งานนำเสนอเรื่อง: "Dr. Suppasin Soontrapa Department of Orthopedics Khon Kaen University, Khon Kaen, Thailand Trace elements."— ใบสำเนางานนำเสนอ:
Dr. Suppasin Soontrapa Department of Orthopedics Khon Kaen University, Khon Kaen, Thailand Trace elements
Vitamin and mineral Calvin Plus 1’s RDA*Thai RDA Calcium600 mg mg800 mg Vitamin D200 iu iu200 iu Magnesium40 mg mg350 mg Zinc7.5 mg12-15 mg15 mg Copper1 mg2 mg Manganese1.8 mg2-5 mg3.5 mg Boron0.25 mgnone *Ref: ค่าสารอาหารที่แนะนำให้บริโภคประจำวันสำหรับคนไทยอายุตั้งแต่ 6 ปีขึ้นไป (Thai Recommended Daily Intakes– Thai RDI) จัดทำโดย คณะอนุกรรมการ พิจารณาการแสดงคุณค่าทางโภชนาการบนฉลากของอาหาร 2538
Magnesium Magnesium is found in small amount in the human body Element% of total atoms H O C N Ca P Cl K S Na Mg Elemental Composition of the Human Body (http://ods.od.nih.gov/factsheets/magnesium.asp#h2)
Magnesium Approximately 50% of total body magnesium is found in bone. The other half is found predominantly inside cells of body tissues and organs. Only 1% of magnesium is found in blood (http://ods.od.nih.gov/factsheets/magnesium.asp#h2)
l Magnesium has positive charge l Magnesium has many necessary function in cells Co-factor in many basic cellular function especially in process of energy production l Magnesium is needed for more than 300 biochemical reactions in the body The function of Magnesium
regulate blood sugar levels promotes normal blood pressure to be involved in energy metabolism and protein synthesis Maintain normal muscle and nerve function keeps heart rhythm steady supports a healthy immune system keeps bones strong. The function of Magnesium
Magnesium is absorbed in the small intestines. Magnesium is excreted through the kidneys Magnesium
Green vegetables –spinach are good sources of magnesium because the center of the chlorophyll molecule (which gives green vegetables their color) contains magnesium. Some legumes (beans and peas), nuts and seeds whole grains, unrefined grains are also good sources of magnesium Sources of Magnesium
DRIs (Dietary Reference Intakes) Recommended Dietary Allowances (RDA) –The RDA recommends the average daily intake that is sufficient to meet the nutrient requirements of nearly all (97-98%) healthy individuals in each age and gender group
DRIs (Dietary Reference Intakes) –Adequate Intakes (AI) –An AI is set when there is insufficient scientific data available to establish a RDA for specific age/gender groups. –AIs meet or exceed the amount needed to maintain a nutritional state of adequacy in nearly all members of a specific age and gender group
DRIs (Dietary Reference Intakes) –Tolerable Upper Intake Levels (UL) –UL is the maximum daily intake unlikely to result in adverse health effects.
Recommended Dietary Allowances (RDAs) for magnesium for children and adults Age (years) Male (mg/day) Female (mg/day) Pregnancy (mg/day) Lactation (mg/day) N/A N/A N/A
Causes of Magnesium Deficiency Magnesium is absorbed in the intestines and then transported through the blood to cells and tissues. Approximately one-third to one-half of dietary magnesium is absorbed into the body Gastrointestinal disorders impair absorption –Crohn's disease can limit the body's ability to absorb magnesium. Chronic or excessive vomiting and diarrhea may also result in magnesium depletion
signs and symptoms of magnesium deficiency loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, – numbness, tingling, muscle contractions and cramps, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur Severe magnesium deficiency can result in low levels of calcium in the blood (hypocalcemia). Magnesium deficiency is also associated with low levels of potassium in the blood (hypokalemia)
Who may need extra magnesium? specific health problem –poorly-controlled diabetes –persons with alcoholism condition limits magnesium absorption –Individuals with chronic malabsorptive problems such as Crohn's disease, gluten sensitive enteropathy, regional enteritis, and intestinal surgery may lose magnesium through diarrhea and fat malabsorption
Who may need extra magnesium? Older adults are at increased risk for magnesium deficiency. The and National Health and Nutrition Examination Surveys suggest that older adults have lower dietary intakes of magnesium than younger adults 1.Ford ES and Mokdad AH. Dietary magnesium intake in a national sample of U.S. adults. J Nutr. 2003;133: Bialostosky K, et al., Dietary intake of macronutrients, micronutrients and other dietary constituents: United States Vital Heath Stat. 11(245) ed: National Center for Health Statistics, 2002:168.
Magnesium and osteoporosis Bone health is supported by many factors – most notably calcium and vitamin D –some evidence suggests that magnesium deficiency may be an additional risk factor for postmenopausal osteoporosis Several human studies have suggested that magnesium supplementation may improve bone mineral density Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press. Washington, DC, 1999
Magnesium and osteoporosis magnesium deficiency alters calcium metabolism and the hormones that regulate calcium 1 In a study of older adults, a greater magnesium intake maintained bone mineral density to a greater degree than a lower magnesium intake 2 1.Elisaf M, Milionis H, Siamopoulos K. Hypomagnesemic hypokalemia and hypocalcemia: Clinical and laboratory characteristics. Mineral Electrolyte Metab 1997;23: Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 1999;69(4):
Conclusion Magnesium is very important in older adults to maintain many functions Magnesium deficiency usually found in poor controlled DM, alcoholism, chronic malabsorptive problems, ect. magnesium supplementation may improve bone mineral density and prevent osteoporosis
What is copper? copper is a trace mineral that plays an important role in our metabolism, it allows many critical enzymes to function properly. the total amount of copper in the body is only mg Copper stored primarily in the liver, with lesser amounts found in the brain, heart, kidney, and muscles
The function of copper? Copper is an essential component of many enzymes. Copper plays a role in a wide range of physiological processes including – iron utilization, –elimination of free radicals, –development of bone and connective tissue, –production of the skin and hair pigment called melanin.
Iron Utilization Approximately 90% of the copper in the blood is incorporated into a compound called ceruloplasmin, which is a transport protein responsible for carrying copper to tissues that need the mineral. ceruloplasmin also acts as an enzyme, catalyzing the oxidation of iron.
Iron Utilization The oxidation of iron by ceruloplasmin is necessary for iron to be bound to its transport protein (called transferrin) so that it can be carried to tissues where it is needed. Iron deficiency anemias may be a symptom of copper deficiency.
Elimination of Free Radicals Superoxide dismutase (SOD) is a copper- dependent enzyme that catalyzes the removal of superoxide radicals from the body. Superoxide radicals are generated –during normal metabolism –white blood cells attack invading bacteria and viruses (a process called phagocytosis). If not eliminated quickly, superoxide radicals cause damage to cell membranes
Elimination of Free Radicals When copper is not present in sufficient quantities, the activity of superoxide dismutase is diminished The damage to cell membranes caused by superoxide radicals is increased
Development of Bone & Connective Tissue Copper is also a component of lysyl oxidase, an enzyme that participates in the synthesis of collagen and elastin
Melanin Production Tyrosinase, a copper-containing enzyme, converts tyrosine to melanin, which is the pigment that gives hair and skin its color.
The symptoms of copper deficiency iron deficiency anemia ruptured blood vessels osteoporosis elevated LDL cholesterol and reduced HDL cholesterol levels increased susceptibility to infections due to poor immune function loss of pigment in the hair and skin weakness, fatigue, breathing difficulties
The risk factors of copper deficiency ? most Americans consume less than recommended amounts of copper in their diet Certain medical conditions result in decreased absorption of copper and may increase the risk of developing a copper deficiency –chronic diarrhea –celiac sprue –Crohn's disease
The risk factors of copper deficiency ? copper requires sufficient stomach acid for absorption, so if you consume antacids regularly you may increase your risk of developing a copper deficiency.
RDAs of Copper Boys & girls 9-13 years: 700 g Boys & girls years: 890 g Men & women years: 900 g Men & women >70 years: 900 g Pregnant & women years: 1000 g Lactating women years: 1300 g
Conclusion Copper have many functions in man Most US people consume less amounts of copper than recommended Copper in calvin plus = 1 mg can supplement adequate amount of copper per day
Zinc: What is it? Zinc is an essential mineral that is found in almost every cell. It stimulates the activity of approximately 100 enzymes, which are substances that promote biochemical reactions in the body, including alkaline phosphatase 1-2 Zinc supports a healthy immune system Sandstead HH. 1994;124: Institute of Medicine. National Academy Press. Washington, DC, Solomons NW. Nutr Rev 1998;56: Prasad AS. Zinc: An overview. Nutrition 1995;11:93-99
Zinc: What is it? Zinc is needed for wound healing 1 maintain your sense of taste and smell 2 Zinc is needed for DNA synthesis 3 Zinc also supports normal growth and development during pregnancy, childhood, and adolescence 4,5 1. Heyneman CA. Ann Pharmacother 1996;30: Prasad AS, et al. Proc Assoc Am Physicians 1997;109: Institute of Medicine. National Academy Press. Washington, DC, Simmer K and Thompson RP. Acta Paediatr Scand Suppl 1985;319: Fabris N and Mocchegiani E. Aging (Milano) 1995;7:77-93.
What foods provide zinc? Zinc is found in a wide variety of foods 1 Oysters contain more zinc per serving than any other food, Red meat and poultry provide the majority of zinc in the American diet. Other good food sources include beans, nuts, certain seafood, whole grains, fortified breakfast cereals, and dairy products Institute of Medicine. National Academy Press. Washington, DC, U.S. Department of Agriculture, Agricultural Research Service Nutrient Data Laboratory Home Page, Search the database online.
The 2001 RDAs for zinc for infants 7 through 12 months, children and adults in mg per day Age Infants and Children MalesFemales Pregnancy Lactation 7 mo. to 3 years 3 mg 4 to 8 years5 mg 9 to 13 years8 mg 14 to 18 years 11 mg9 mg13 mg14 mg mg8 mg11 mg12 mg Institute of Medicine. National Academy Press. Washington, DC, 2001
Low zinc status has been observed in 30% to 50% of alcoholics. –Alcohol decreases the absorption of zinc and increases loss of zinc in urine. –Many alcoholics do not eat an acceptable variety or amount of food, so their dietary intake of zinc may be inadequate 1-3 Inadequate intake of zinc 1.Institute of Medicine. National Academy Press. Washington, DC, Menzano E and Carlen PL. Alcohol Clin Exp Res 1994;18: Navarro S, et al., Pancreas 1994;9:
Individuals who have had gastrointestinal surgery Digestive disorders that result in malabsorption –including sprue –Crohn’s disease –short bowel syndrome 1-3 These patients may benefit from zinc supplementation Inadequate intake of zinc 1.Institute of Medicine. National Academy Press. Washington, DC, Hambidge KM, In: Mills CF, ed. Zinc in Human Biology, New York: Springer-Verlag 1989 Pp Naber TH, et al., Scand J Gastroenterol 1998;33:
Signs of zinc deficiency growth retardation hair loss diarrhea delayed sexual maturation impotence eye and skin lesions loss of appetite Institute of Medicine. National Academy Press. Washington, DC, 2001.
weight loss delayed healing of wounds taste abnormalities mental lethargy Hambidge KM, In: Zinc in Human Biology, 1989 Pp King JC and Keen CL. In: Modern Nutrition in Health and Disease, 1999, Pp Krasovec M and Frenk E. Dermatology 1996;193: Ploysangam A, et al., J Trop Pediatr 1997;43: Nishi Y. J Am Coll Nutr 1996;15: Signs of zinc deficiency
Who may need extra zinc? There is no single laboratory test that adequately measures zinc nutritional status 1-2 risk factors of zinc deficiency 1 –inadequate caloric intake –alcoholism –digestive diseases 1.Institute of Medicine. National Academy Press. Washington, DC, Van Wouwe JP. Clinical and laboratory assessment of zinc deficiency in Dutch children. A review. Biol Trace Elem Res 1995;49:
Who may need extra zinc? Vegetarians may need as much as 50% more zinc than non-vegetarians because of the lower absorption of zinc from plant foods it is very important for vegetarians to include good sources of zinc in their diet Institute of Medicine. National Academy Press. Washington, DC, Gibson RS. Content and bioavailability of trace elements in vegetarian diets. Am J Clin Nutr 1994;59:1223S-1232S.
Conclusion Zinc is an essential mineral for many function including bone growth Many people consume inadequate zinc especially vegetarians Zinc in calvin plus = 7.5 mg can supply about 50% of daily requirement of zinc
ความต้องการโบรอนในมนุษย์ คาดกันว่ามนุษย์มีความต้องการ โบรอนในปริมาณ 500 g/d จากข้อเสนอแนะของ The Food and Nutrition Board of the Institute of Medicine พบว่า โบรอนสูงสุดที่มนุษย์ที่มีอายุ มากกว่า 18 ปีสามารถรับได้คือ 20 mg/day
Evidence Grading Grading A: Strong scientific evidence for this use B: Good scientific evidence for this use C: Unclear scientific evidence for this use D: Fair scientific evidence against this use F: Strong scientific evidence against this use
Uses based on scientific evidence Gra de Hormone regulation Boron may increase hormone (estrogen) levels in women, reducing vaginal discomfort after menopause. More research is needed in humans before a strong conclusion can be reached. C Improving cognitive function Preliminary human study reports better performance on tasks of eye-hand coordination, attention, perception, short- term memory, and long-term memory with boron supplementation. However, additional research is needed before a firm conclusion can be drawn. C Evidence Grading
Uses based on scientific evidence Gra de Osteoarthritis Based on human population research, in a boron rich environment, people appear to have fewer joint disorders. It has also been proposed that boron deficiency may contribute to the development of osteoarthritis. However, there is no clear human evidence that supplementation with boron is beneficial as prevention against or as a treatment for osteoarthritis. C Evidence Grading
Uses based on scientific evidence Gra de Osteoporosis Animal and preliminary human studies report that boron may play a role in mineral metabolism, with effects on calcium, phosphorus, and vitamin D. However, research of bone mineral density in women taking boron supplements does not clearly demonstrate benefits in osteoporosis. Additional study is needed before a firm conclusion can be drawn. C Evidence Grading
Uses based on scientific evidence Gra de Vaginitis Inorganic boron (boric acid, borax) has been used as an antiseptic based on proposed antibacterial and antifungal properties. It is proposed that boric acid may have effects against candidal and non-candidal vulvovaginitis. A limited amount of poor-quality research reports that boric acid capsules used in the vagina may be effective for vaginitis. Further evidence is needed before a recommendation can be made. C Evidence Grading
Uses based on scientific evidence Gra de Bodybuilding aid (increasing testosterone) There is preliminary negative evidence for the use of boron for improving performance in bodybuilding by increasing testosterone. Although boron is suggested to raise testosterone levels, in early human research, total lean body mass has not been affected by boron supplementation in bodybuilders. Additional research is necessary before a firm conclusion can be drawn. D Evidence Grading
Uses based on scientific evidence Gra de Menopausal symptoms It has been proposed that boron affects estrogen levels in post-menopausal women. However, preliminary studies have found no changes in menopausal symptoms. D Evidence Grading
Uses based on scientific evidence Gra de Prevention of blood clotting (coagulation effects) It has been proposed that boron may affect the activity of certain blood clotting factors. Study results conflict. There is not enough evidence in this area to form a clear conclusion. D Psoriasis (boric acid ointment) Preliminary human study of an ointment including boric acid does not report significant benefits in psoriasis. D Evidence Grading