Major Minerals

Question 1

The more a food is processed, the greater the ratio of potassium to sodium

Answer 1

true

Question 2

Bone health involves a variety of minerals. Select all that apply for full mark

Selected Answers:

Phosphorus
Vitamin D
Vitamin K
Magnesium
Sulfur

Answer 2

Selected Answers:

Phosphorus

Magnesium

minerals not vitamins

Question 3

Which of the following is a parameter considered when making the distinction between major and minor/trace minerals?

Answer 3

5.

How much of these minerals are needed by the body?

Question 4

Chloride is the main _____________

Answers:
1.
Cation in extracellular fluid

2. Anion in intracellular fluid
3. Electrolyte in interstitial fluid
4. Cation in intracellular fluid

Correct5.
Anion in extracellular fluid

Answer 4

5.

Anion in extracellular fluid

Question 5

In addition to its role in bone development and maintenance, calcium is also required for:
Vitamin D absorption, muscle contraction and neurotransmitter production

2. Magnesium absorption, blood clotting function, and blood pressure regulation

Correct3.
Blood clotting, transmission of nerve impulse, muscle contraction

4. ATP stabilisation, muscle contraction, and DNA synthesis
5. Regulating potassium excretion, kidney function, and regulation of intracellular fluid

Response Feedback:
These are the typical functions of calcium besides in bone health. Look at the pictures in the lecture material that illustrate them.

Answer 5

Blood clotting, transmission of nerve impulse, muscle contraction

Question 6

The DASH is a prescriptive dietary approach to address primary hypertension. Which of the following best describe the mechanisms of actions of the DASH (select all that apply for full mark):

Low fiber intake to avoid bile excretion and promote entero-hepatic circulation

2. High carbohydrate and low fat intake to promote appetite control and weight loss
3. A high sodium to potassium ratio to promote water excretion
4. A high dietary calcium and magnesium intake for blood vessel vasodilation and relaxation
5. A high potassium to sodium ratio to promote water excretion

Answer 6

Correct4.
A high dietary calcium and magnesium intake for blood vessel vasodilation and relaxation

Correct5.
A high potassium to sodium ratio to promote water excretion

Question 7

acid found in dietary fibre interferes with mineral bioavailability for absorption.
All Answer Choices
Citric
Oxalic
Phytic
Phenolic
Acetic
Ascorbic
Amino

Answer 7

Correct Phytic acid found in dietary fibre interferes with mineral bioavailability for absorption.

hytic acid in fibre and oxalic acid is green leafy vegetables (but not associated with the fibre in these vegetables)

Question 8

Match the following anions and cations with the right fluid compartment where they mostly prevail: ECF or ICF

Potassium 
magnesium 
Phosphate 
SUlfur 
Sodium 
Calcium 
CHloride 
Bicarbonate

Answer 8

Potassium ICF
magnesium ICF
Phosphate ICF
SUlfur ICF
Sodium ECF
Calcium ECF
CHloride ECF
Bicarbonate ECF

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Question 9

On your travel overseas you buy a packet of local crisps. You are curious about the sodium content in a 100 grams of crisps. The NIP is limited on the packaging; it indicates that the 125 g packet of crisps contains 5.35g of salt. How much sodium (in mg) is this equivalent to per 100 g of crisps?

Answer 9

Correct Answer:

Correct 1,682.04

Question 10

Which of the following is most likely to be secreted first when blood calcium levels drop: [A]

Answer 10

Parathyroid hormone

Question 11

In the usual diets of populations in developed countries, the sodium content comes from the following sources:
1.
77% from processed /restaurant foods, 12% from naturally occurring in food, 6% from adding salt to the meal, 5% from cooking with salt

2. 77% from cooking with salt and soy sauce, 10% from natural food sources, 10% added to the plate, 3% from packaged foods
3. 77% from naturally occurring foods, 12 % from processed /restaurant foods, 6% from cooking with salt, 5% from adding salt to the meal
4. 77% from cooking with salt and savoury sauces, 12% from naturally occurring in foods, 6% from processed /restaurant foods, 5% from adding salt to the meal
5. 75% from processed /restaurant foods, 25% from sauces added to dishes, 25% from natural food sources

Answer 11

Correct1.
77% from processed /restaurant foods, 12% from naturally occurring in food, 6% from adding salt to the meal, 5% from cooking with salt

Question 12

Which of the following is likely to be secreted first when blood calcium rise above the normal range:

Answer 12

Calcitonin

Question 13

High potassium diet reduces [A] excretion

Answer 13

Calcium

Question 14

Calcium homeostasis is tightly regulated by a number of hormones which includes (select all that apply for full mark):
1.
Aldosterone

2. Calcitriol
3. Insulin
4. Thyroid hormone
5. Calcitonin

Answer 14

2. Calcitriol
   Calcitriol promotes
   bone resorption
3. Calcitonin

Review the diagram about calcium homeostasis: calcitriol, calcitonin and PTH are the hormone to remember overall for that mechanism

Question 15

On the nutrition information panel of a bottle of barbecue sauce, you see that there is 1150mg of sodium per 100 mL of sauce. You estimate that you are consuming about 40 mL of sauce with your dinner meal. How much salt ( in mg) is this equivalent to?

Answer 15

Correct Answer:
Correct 1,170
Answer range +/-
10 (1160 - 1180)

Review the calculations to convert sodium to salt and vice-versa

Question 16

Bone is the main storage of ______________ whilst muscles contain a significant amount of ___________.

Answer 16

Magnesium, calcium and phosphorus; magnesium

Question 17

Remember the Traditional Mediterranean Diet from your lipid week studies? What do you think: is it overall low in ______________ and high in ______________?

Answer 17

1.

Sodium; potassium

Question 18

[A] acid found in green leafy vegetables interfere with mineral bioavailability for absorption.

Answer 18

Oxalic acid found in green leafy vegetables interfere with mineral bioavailability for absorption.

Question 19

The NRVs for sodium include:

Selected Answer:
5.
The SDT of 2000 mg

Answers:
1.
The UL of 3000 mg

2. The AI of 2300 mg
3. The RDI of 2300 mg
4. The EAR of 200 mg

Correct5.
The SDT of 2000 mg

Answer 19

5.

The SDT of 2000 mg

Question 20

High potassium intake promotes:

Answer 20

Sodium excretion

Question 21

Both deficiency and excess of _________________ lead to_______________:
Potassium; cardiac arrhythmia

2. Chloride; failure to thrive
3. Phosphorus; respiratory failure
4. Sodium; muscle cramping
5. Calcium; decreased magnesium absorptio

Potassium; cardiac arrhythmia

Answer 21

Potassium; cardiac arrhythmia

Question 22

Mineral absorption is influenced by numerous factors. Which of the following statement is incorrect:
1.
Calcium is best absorbed in the upper duodenum

2. Calcitriol increases phosphorus absorption
3. Tannins and polyphenols enhance minerals absorption
4. Vitamin D deficiency results in impaired calcium absorption
5. A valence of 2+ promotes minerals absorption

Answer 22

3.

Tannins and polyphenols enhance minerals absorption

Question 23

Salt substitutes often contain

Answer 23

Potassium chloride

Question 24

Mineral essentiality is based on the following EXCEPT:

The fact that the body does not produce minerals endogenously

2. The fact that deficiencies, if not addressed early, may lead to permanent health consequences
3. How depleted in the specific minerals the soil in the region is
4. How crucial these nutrients are to health despite low amounts required
5. The fact that deficiencies result in identifiable characteristic symptoms

Answer 24

3.

How depleted in the specific minerals the soil in the region is

Question 25

``` All of the following play a role in calcium homeostasis EXCEPT: [A] All Answer Choices 1,25 (OH)2 cholecalciferol Calcitonin Thyroxine Parathyroid hormone Thyroid gland Parathyroid glands ```

Answer 25

Thyroxine

Question 26

What are the major minerals

Answer 26

``` Calcium phosphorus potassium sulfur sodium chloride magnesium ```

Question 27

what impairs bioavailability of minerals

Answer 27

Excess fibre (above 38 g/day) may lead to lower mineral status - Phytic acid found in fibre (phytate in legumes and whole grains): binds to minerals & results in mineral excretion - Leavened breads with baker's yeast may break the bonds between phytates and the minerals: ↑ bioavailability of minerals • Oxalic acid in dark green leafy vegetables (not associated with fibre) binds minerals and makes them less available for absorption - E.g. calcium in spinach: 5% versus 32% absorbed for calcium from dairy • Polyphenols and tannins can reduce bioavailability of iron and calcium in particular - E.g. tea black, dark chocolate, red wine contain high amount of tannins that interfere with iron absorption • Consumption of several minerals of the same valence at once can decrease absorption of each (e.g. in multi-minerals supplements): - E.g. Zinc (2+ ); iron (2+ ); calcium (2+ ) and other 2+ valences compete for absorption when taken together

Question 28

what improves bioavalibility of minerals

Answer 28

Vitamin C: improves non-haem iron absorption within the same meal • Stomach acidity: assists in converting minerals from 3+ to 2+ : helps their absorption (because 2+ is the absorption form for minerals) Therefore antacids may impair bioavailability of minerals, because of reduced stomach acidity • Good vitamin D status facilitates dietary calcium absorption (because calcitriol upregulates expression of TRPV6 (calcium channel proteins), calbindin and calcium ATPase-pumps) • In general, human absorption of minerals increases when needs are greater • NOTE: mineral content listed on labels doesn’t reflect actual absorption, but the content in the tablet. Before using supplements, a full nutrient status analysis should be performed.

Question 29

functions of sodium

Answer 29

``` Maintenance of intra and extracellular fluid volume (including plasma and interstitial fluid) 2. Assists in the absorption of glucose and amino acids in the small intestine (e.g: SLGT for glucose) 3. Muscle and nerve function: membrane potential of cells 4. Note: salty taste is appetizing. Promotes food intake in anorexia ```

Question 30

calculating sodium salt

Answer 30

Table salt = NaCl; 39.3% of salt is sodium • Multiply by 0.393 the amount of salt to know how much sodium is contained in a given amount of salt • Divide amount of sodium by 0.393 to find out to how much salt this is equivalent to • E.g: SDT for sodium = 2000 mg / 0.39= 5 128 mg = ~5 g = ~1 small teaspoon of salt (all inclusive throughout the day)

Question 31

sodium deficiency

Answer 31

Deficiency • Hyponatremia: headache, nausea, vomiting, muscle cramps, fatigue, disorientation, cerebral edema fainting and coma if left untreated rapidly • Occurs when losses exceed intake: with excessive diarrhea and vomiting, or excessive sweating (>2% of total body weight)

Question 32

excess sodium

Answer 32

Toxicity • Hypernatremia due to excessive water losses => low blood pressure, fainting, stupor, convulsions Other effects in high intake: • >2 g /day can increase urinary calcium losses • Salt-sensitive people: primary hypertension (25-50%) and thus increased risk of heart disease and stroke

Question 33

Potassium

Answer 33

Major cation in intracellular fluid 2. Contractility of smooth, skeletal and cardiac muscle, and excitability of nerve tissue: responsible for changing the electrical potential during depolarisation / repolarisation of nerve/muscle cells for conduction of impulse 3. High (dietary) potassium intake reduces serum calcium excretion 4. High potassium intake promotes sodium + H20 excretion: resulting in reduced blood volume, and reduced blood pressure in HTN. This is the main mechanism of action of the DASH (see further)

Question 34

potassium deficiency

Answer 34

Deficiency • Hypokalemia leads to cardiac arrhythmia, muscle weakness, fatigue, hypercalciuria, glucose intolerance • Usually due to profound fluid loss rather than lack of intake: vomiting, diarrhea, use of diuretics, eating disorders, alcoholism (poor diet), athletes with excessive sweating

Question 35

Potassium toxcicity

Answer 35

Toxicity • Hyperkalemia results in cardiac arrhythmia and cardiac arrest, muscle weakness and temporary paralysis, gastrointestinal ulceration and perforation. Does not occur from dietary intake, but through supplements use, or use of salt substitute: potassium chloride (to replace salt in low-salt diets) In chronic kidney disease: potassium is not well excreted; restriction of dietary potassium is required, which affects quality of life because many foods are limited or excluded. Use of potassium binders may also be prescribed.

Question 36

Chloride

Answer 36

1. Electrical neutrality: balancing sodium positive charge 2. Main anion for ECF 3. Fluid balance 4. Acid/base balance 5. Nerve impulse transmission 6. Component of: - NaCl - HCL

Question 37

chloride deficiency

Answer 37

Deficiency • Loss of appetite • Failure to thrive • Muscle weakness, lethargy, convulsions • Severe metabolic alkalosis on blood test Deficiency is usually rare as it is consumed as part of salt. Has occurred in infants fed chloride deficient formula. May occur in GIT disorders with excessive diarrhea and vomiting.

Question 38

CALCIUM HOMEOSTASIS

Answer 38

ELEVATED - calcitonin

Question 39

function of calcium

Answer 39

1- Bone development and maintenance: • Forms calcium-hydroxyapatite with phosphate: • Strong lattice-like structure that binds to collagen • Hydoxyapatite allows strength of bone • Collagen allows flexibility • Bone remodeling: total skeleton replaced every 10 years through the activity of: - Osteoblasts: build bone - Osteoclasts: break bone 2- Blood clotting: calcium involved in the blood clotting factors formation cascade. Ca binds to the gamma carboxy-glutamic acid in prothrombin (activated through the gamma carboxylation with vitamin K as cofactor) 3- Muscle contraction: • Calcium ions released when nerve impulse reaches myocytes • Calcium triggers muscle proteins to contract • When calcium is transported back into the intracellular storage site: relaxation of muscle fibre Tetany= spontaneous nerve impulses from too little calcium, results in muscle spasms 4- Transmission of nerve impulses: influx of calcium ions when nerve impulse reaches cell • Trigger vesicles recruitment to presynaptic membrane • Vesicles release neurotransmitters which carry the impulse across the synapse into target cell 5- Other function: • Helps decrease blood pressure by smooth muscle relaxation in blood vessels

Question 40

BONE HEALTH

Answer 40

``` Bone health: Bone building nutrients include more than just calcium: protein, vitamin D, vitamin K, vitamin C, potassium, magnesium, phosphorus, copper, fluoride Active lifestyle with weight bearing exercise at critical age (until 25-30 years is ”bone building age”)to build maximum bone mass Drug therapy to reduce osteoclasts activity = bisphosphonates ```

Question 41

calcium deficiency

Answer 41

Deficiency • Hypocalcemia: muscle cramp, paresthesia, confusion, fatigue, anxiety • Low and very low bone mass: osteopenia and osteoporosis

Question 42

calcium toxcicity

Answer 42

Toxicity • Hypercalcemia can lead to kidney stones, high blood pressure (calcification of blood vessels), renal calcification and failure • High risk of toxicity with supplements: at above 1500 mg daily=> risk of calcium deposit in coronary artery. • If using supplements: calcium carbonate and calcium citrate appear best; mays be combined with vitamin D3 or calcitriol (prescription). Limit to 500 mg dose and take with food • Risk of interference with absorption of other minerals : e.g. iron, zinc, magnesium

Question 43

DASH DIET

Answer 43

High potassium to sodium ratio*: high K intake promotes sodium and water excretion, reducing blood volume and thus HTN. *The DASH is about the combination of both high K and low Na (or “high K/Na ratio”; or “low Na/K ratio”) 2- High in magnesium intake, high calcium intake: magnesium and calcium act as smooth muscle relaxant and vasorelaxant e.g. blood vessels elasticity is maintained, thus allowing for adaptation to blood volume and reducing HTN. 3- Low in sodium (down to 1500-2300 mg): for salt sensitive individuals, this will reduce water retention, e.g. blood volume and thus HTN. In overweight subjects, high salt intake tends to promote more food intake because it is appetizing, worsening the energy balance and struggles to lose weight. Excess weight is a risk factor for HTN. So if relevant for that person, weight loss can assist in reducing HTN. 4- Moderate total fat, low saturated fat and low cholesterol intake: improvement of blood lipid profile, reducing the risk of LDL build up and peroxidation, and thus risk of arteriosclerosis which hardens the arterial wall, and narrows the lumen leading to HTN. 5- High fibre: can assist in appetite control to avoid over-snacking where over-weight is an issue, and the resulting weight loss can reduce HTN. Fibre also contributes to reduced cholesterol “re-absorption” via bile reabsorption, which results in reduced blood cholesterol when new bile is made by the liver. This improves the lipid profile and reduces arteriosclerosis risk, thus reducing the risk of HTN via the hardening of blood vessels. 6- Avoid added sugar: improves blood glucose management which reduces the risk of endothelium damage due to inflammation, and thus the risk of arteriosclerosis development and the related effect on HTN. 7- High in vegetables and fruit provides plant sterols. What is the mechanisms that may prevent HTN?

Question 44

How are phosphorus, calcium and magnesium involved in bone health specifically?

Answer 44

phosphorus - 85% found in bones and teeth as hydroxyapatite • The rest is in all other cells and ECF Magnesium- 50% found in bone: as part of calcium-hydroxyapatite Calcium- - Bone development and maintenance: • Forms calcium-hydroxyapatite with phosphate: • Strong lattice-like structure that binds to collagen • Hydoxyapatite allows strength of bone • Collagen allows flexibility

Question 45

describe steps when calcium up or down

Answer 45

a- When blood calcium levels drop parathyroid releases parathyroid hormone to 1. Stimulate calcium release from bones 2. Increase calcium uptake in intesitnes 3. Increase calcium retention in kidneys b- When blood calcium levels rise to excess calcitriol 1. Decrease calcium release from bones 2. Increase calcium excretion in kidneys