Lesson 3

Topics to discuss

1. Minerals

2. Current pattern of nutrient intake and

3. Dietary recommendations / Dietery guidelines / Healthy dietrecommendations - Are they needed?

• the most relevant minerals:

Ca, Fe, Cu, Zn, Se,

Na, K, Mg, I, P

Minerals

Function

• essential nutrients

• metabolism – part of enzyme systems

• components of body fluids

• building components of tissues (e.g. bones, erythrocytes)

Sources

• a variety of foods of animal and plant origin

Iron

Iron deficiency anemia

• the most common nutritional deficiency

Function

building component of haemoglobin

component of enzyme systems

Clinical case

• in a 18 – y old teenager mild microcytic anemia and erythrocytopenia was found

• anamnesis and lab results indicates that nutrition may be oneof the causes

• what change on diet is needed?

Iron deficiency anemia

Current iron intake

On average adequate (USA, Central Europe)

Who is at risk of low intakes?

adolescent girls, young females

(low iron diets, losses – menstrual

cycle, pregnancies)

toddlers around 6 months (low iron

content in breastmilk + if solid food

intake is delayed)

elderly (impaired digestion and

absorption, poor diet due to economic

situation)

vegans – meatless diet

Consequences of low intake

- most common - microcytic anemia

Iron - sources

Nonheme iron

• some vegetables, legumes, wholegrain, cereals, nuts, eggs and iron-

fortified foods

Heme iron

• meat and fish

• from the blood hemoglobin and myoglobin in the muscles

• Heme iron is about 1.8 times as bioavailable as nonheme iron

= about twice as much iron from plant foods needed than from animal

foods to get the same effect

Iron absorption - modulated by other food components

+ vitamin C

- tannins, phytates, oxalates, fibre (tea, veggies, wholegrains)

strong bond prevents Ca absorption

Foods rich in iron

Clinical case

- Why are we encouraged to consume enough calcium?

- Is it an issue of - Children?

- Adolescents?

- Adults?

- Elderly?

- Patients?

- Vegetarians?

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Calcium (Ca)

Calcium (Ca)

Current intake

• lower than recommended

Calcium plasma levels

• strictly controlled by hormones

Functions

- the most abundant mineral in the human body (1500 g)

- building component – bones, teeth (99 %)

- hemocoagulation

- nerve and muscle function

- part of enzyme systems

Accumulation Losses

Age related changes in bone density

Risks of insufficient intake

• Impaired bone and teeth formation (childhood, adolescence) – lower mineral

content -„strength“

• Ca losses from bones in order to maintain normal calcemia (adulthood) – risk of

osteoporosis

Higher Ca requirements

- childhood, adolescence

- pregnancy

- lactation

Calcium (Ca)

Calcium

Sources

animal: milk, milk products, cheese

plant:

poppy sed, soya, legumes, some

vegetables, wholegrain cereals,

oat flakes, nuts and seeds

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Function

• component of body fluids – maintenance of constant volume

• transmembrane potential

Sources

- Salt and salt containing foods (crackers, salted peanuts, salami,

sausages, bread, pickled vegetables, etc.)

• Na Cl (salt)

• currently excessive consumption

• Increases risk of high blood pressure

• recommended to reduce intake (na 5 – 8 g/day)

Sodium (Na)

Iodine

- component of thyroid hormones – T3, T4

- Sources: seafood, iodized salt

Minerals Function Sources

Calcium bone and teeth formation, blood clotting,

muscle contraction, function of nerves

dairy, broccoli, green leafy vegetables,

whole grains, soy, legumes, sardines

Phosphorus bone and teeth formation, metabolism, buffer

system, phosphate bonds

dairy products, meat, fish, eggs,

wholegrain products, vegetables, fruit

Magnesium metabolism, bone formation whole grains, leafy green vegetables,

nuts, soybeans, legumes, poultry

Sodium transmembrane potential, osmotic pressure,

water volume, ion in the extracellular fluid

salt, salt containing foods

Potassium transmembrane potential, essential ion in the

intracellular fluid

vegetables, bananas, prunes, meat, milk,

whole grains

Chlorine essential ion in the extracellular fluid, fluid and

electrolyte balance, aids in digestion

salt, salt containing foods, seafood

Sulphur component of amino acids, involved in

antioxidant defence

meat, fish, eggs, legumes, dairy products,

onions, cabbage, garlic, wheat germ

Iron transport of oxygen red meat, eggs, leafy green vegetables,

legumes, whole grains

Selenium antioxidant eggs, fish, whole grain products, legumes

Zinc component of enzymes, antioxidant, immunity meat, oysters, liver, eggs, soy, cheese,

legumes, cocoa, cereals

Copper cellular respiration, energy metabolism,

antioxidant, red blood cell formation

eggs, meat, liver, nuts, whole grain

products, cocoa

Fluorine prevention of dental caries, bone formation fluorinated salt, tea, sea fish

Iodine synthesis of thyroid hormones iodized salt, fish, seafood

Developed countries

(Western and Central Europe, USA)

- food is availabile in more than adequate amounts

- overeating - excessive energy intake + imbalanced of nutrient intake

Typical nutrient intake:

Excessive intake of

- fat, especially saturated FA

- sugar

- sodium chloride (salt)

- alcohol

Inadequate intake of

- dietary fibre

- many vitamins (D, B, C)

- many minerals

- recent scientific evidence indicates not fullyadequate dietary patterns of the populations

Dietary recommendations - are they needed?

Many cases can be prevented.Healthy diet can decrease the risk of health disorders !!!

Health consequences

- imbalanced diet and bad lifestyle increase the risk of serious diseases

- at present time - most serious and most frequent disease

- major health problem

Eat healthy diet!What is a healthy diet?

A healthy diet must supply

• all nutrients required for normal function of the body

• in adequate quantity

– lack but also excess of nutrients has adverse effects on the body

Healthy diet

- contains all different kinds of foods:

cereals, fats, vegetables, fruit, milk,

meat, legumes, nuts, fish, etc.

- is based on consumption of a variety of

foods within the basic food groups (e.g.

different kinds of fruit, vegetables,

legumes)

- colourful diet

Dietary recommendations

• Eat all different kinds of foods: cereals, fats, vegetables, fruit, milk, meat, legumes, nuts, fish, etc.

• Consume a variety of foods within the basic food groups (e.g. different kinds of fruit, vegetables, legumes)

• Increase daily intake of • fruits and vegetables

• Increase daily intake of • milk and milk products, prefer the low fat products

• Choose fats wisely for good health.• prefer plant oils rich in unsaturated fat• limit animal fats rich in saturated fat and cholesterol (butter, lard)• cut back on foods high in fat

- help to make a healthy food choice

- help to achieve balanced nutrient intake

Dietary recommendations

• Choose carbohydrate rich foods wisely for good health

• limit white cereals

• consume mostly wholegrain cereals rich in dietary fibre

• limit mono and disaccharides

• Choose and prepare foods with little or no salt

• Control calorie intake to manage body weight.

• regularly 3 – 6 times per day

• Consume adequate volume of beverages

• cut back on beverages high in calories and low in nutrition, such as soft drinks

• If you drink alcoholic beverages, do so in moderation.

Recommended daily amounts

- tables with recommended

daily intake of nutrients

- consider

- gender (male, female),

- age

- physical activity

- other factors

Questions

• Haem and non haem iron – their absorption and food sources

• Food componens that enhance or inhibit iron absorption

• Calcium – food sources

• Bone density changes with age

• Typical pattern of nutrient intake

• Health considerations of salt (Na) intake, sources of Na

• Diseases/health risks associated with current dietary patterns

• Healthy nutrition recommendations

• Recommended nutrient amounts