![References
1. K. Park; textbook of preventive and social medicine; 24th edition.
2. Textbook of public health & community medicine 1st edition;
AFMC Pune (2009); Ashok K. Jindal, Puja Dudeja.
3. Satyanarayana, U. (2008). Biochemistry. 3rd ed. Kolkata: Books and
allied (P) Ltd.
4. Minerals [Internet]. Linus Pauling Institute. 2020 [cited 17 January
2020]. Available from: https://lpi.oregonstate.edu/mic/minerals](https://image.slidesharecdn.com/traceelements-minerals-210728064808/85/Trace-elements-minerals-47-320.jpg)
Trace elements minerals
- 2. Nutrition – it is that branch of science, which deals with the study of dynamic process, in which the consumed food is utilized for nourishing the body ( A PROCESS OF ASSIMILATION OF FOOD)
- 3. Macronutrients: -Proteins (7-15 %) -Fats (10-30 %) -Carbohydrates (65-80 %) Micronutrients: -Vitamins -Minerals Organic and inorganic complexes contained in food are called nutrients Classification of nutrients 3
- 4. MINERALS Major minerals :- Calcium Phosphorus Sodium Potassium magnesium Trace elements :- Iron Iodine Fluorine Zinc Copper Trace contaminants :- Lead Mercury Barium Boron Aluminium 4
- 5. Trace elements • Iron, iodine, fluorine, zinc, copper, cobalt, chromium, selenium, molybdenum and manganese Essential trace elements • Nickel, vanadium, cadmium and barium Possibly essential trace elements • Aluminium, lead, mercury, boron, silver, bismuth etc. Non essential trace elements
- 7. IRON • 3-4 grams in body • 60-70 % in blood • 1g Hb = 3.34 mg iron Functions : Hemoglobin formation Brain development Temperature regulation Muscle activity Catecholamine metabolism 7
- 8. Dietary requirements ◦ Adult man – 10 mg/day ◦ Menstruating woman – 18 mg/ day ◦ Pregnant and lactating woman – 40 mg/day
- 9. Rich source • Organ meats Good source • Leafy vegetables • Pulses • Cereals • Fish Poor source • Milk • Wheat • Polished rice Sources
- 10. Absorption, transportation and storage
- 11. Iron losses : 1 mg daily (12.5 mg/ 28 days) Iron deficiency : o Decreased storage o Latent iron deficiency o Overt iron deficiency • Nutritional anemia • Impaired immunity • Diminished work performance 11 Hemosiderosis: excessive iron in the body Hemochromatosis: iron is directly deposited in the tissues.
- 12. • Weakness, easy fatigability, lethargy • Immuno-compromised • Diminished physical and mental capacity • Reduced work capacity, reduced endurance General • Weakness, diminished physical and mental capacity, • Increased morbidity • Increased risk of low birth baby, abortion, premature delivery, intra- uterine growth retardation, • Congenial fetal malformations, PPH, maternal mortality Pregnant and Lactating Women • Low birth weight, Perinatal mortality, • Impaired cognitive performance and motor development, • Psychological and behavioral effects • Inattention, fatigue and insecurity Children Consequences of Anaemia . . . 12
- 13. Breastfeeding and appropriate weaning Dietary modification Deworming Nutrition education Iron supplementation & Iron fortification Prevention & control 13
- 14. National Nutritional Anemia Prophylaxis Program (NNAPP) - Initiated in 1970. - Prophylactic doses of iron and folic acid tablets distributed to high risk groups by the local health workers. - Food fortification and dietary diversification. - Infants between 6 and 12 months, school children 6 to 10 year old and adolescents 11 to 18 years old included in this program. 14 For children 6 to 60 months ferrous sulphate and folic acid are to be provided in a liquid formulation containing 20 mg elemental iron and 100 mcg folic acid per ml of liquid formulation.
- 15. IODINE
- 17. IODINE • 20 mg in body • 80 % in thyroid gland Functions : Synthesis of thyroxine and triiodothyronine 17
- 18. Sources & Dietary requirements Adult man – 100 - 150 μg/day Pregnant woman – 200 μg/day
- 19. Absorption • 30% small intestine • Skin and lungs Storage • 80% as iodo- thyroglobulin in thyroid gland Excretion • Kidney • Saliva, bile, skin and milk (in lactating women)
- 20. Pregnancy Spontaneous Abortion, Still births Fetus Abortions Still births Congenital anomalies Increased perinatal mortality Increased infant mortality Infant Neurological Cretinism Mental deficiency Deaf mutism Spastic diplegia Squint Myxedematous Cretinism Dwarfism Psychomotor defects Neonate Neonatal goitre Neonatal hypothyroidism SPECTRUM OF IODINE DEFICIENCY DISORDERS Child and adolescent Goiter, Juvenile hypothyroidism Impaired mental function Subnormal intelligence (loss of 10 to 15 IQ points) Retarded physical development Delayed motor milestones Hearing and speech defects Stunting and muscle disorder Adult Goitre and its complications Hypothyroidism Lack of energy Impaired mental function Lowered productivity Animal Reproductive failure Decreased yield of milk, egg, etc. 20
- 21. Under the National IDD Control Programme four main components are : 1.Use of Iodized salt or oil 2. Iodine monitoring 3. Manpower training 4. Mass communication Prevention & control 21
- 23. FLUORINE • Found in bones and teeth Functions : Prevents development of dental caries Development of bones Inhibits activities of certain enzymes 23
- 24. Dietary requirements & Sources Intake of less than 2 ppm.
- 25. Intake absorption and excretion
- 26. Fluoride consumption Water Food Toothpaste Air pollution etc. Higher concentration in ground waters than surface waters The optimum concentration for drinking purpose is 0.5 to 0.8 mg/L (ppm) but the permissible upper limit is 1.5 mg/L (1.5 ppm). ‘A double edged sword’. fluorine 26
- 27. fluoride Excess Deficiency Fluorosis Caries (< 0.5 ppm ) - Dental fluorosis (> 1.5 ppm, 0-7 yrs of life) - Skeletal fluorosis (> 10 ppm) Health problem in rural districts of Andhra Pradesh (esp. Nellore, Nalgonda and Prakasham districts), Haryana, Karnataka, Kerala, Punjab, Rajasthan and Tamil Nadu. 27
- 28. Prevention & control Change in water source Defluoridation—The Nalgonda Technique (lime and alum precipitation) Prohibit fluoride fortified water (0.5–0.8 ppm)/ toothpaste in endemic areas 28
- 29. ZINC
- 30. ZINC • Total content in body is 2g • Intracellular element • Found in prostate gland, pancrease and brain 30
- 31. Functions : • Component of more than 300 enzymes • Antioxidant • Storage and secretion of insulin • Promotes synthesis of retinol binding protein • Wound healing • Main content of Gusten protein • Essential for growth of foaetus
- 32. Dietary requirements & Sources ◦ 10 – 15 mg/ day ◦ Increases by 50% in pregnancy and lactation.
- 33. Intake absorption and excretion
- 35. COPPER
- 36. COPPER • 100 – 150 mg in adult body 36
- 37. Functions : Essential component of enzyme Synthesis of hemoglobin Lysyl oxidase is necessary for cross linking structural proteins Ceruloplasmin Synthesis of melanin and phospholipid Development of bones and nervous system
- 38. Dietary requirements & Sources ◦ Adults – ◦ 2 to 3 mg/day ◦ Infants and children – ◦ 0.5 to 2 mg/day
- 39. Intake absorption and excretion
- 41. Cobalt Important as constituent of vitamin B12. Functions are same as that of vit B12. Stimulates production of hormone erythropoietin. Prolonged administration results in polycythemia.
- 44. Molybdenum Constituent of enzymes Absorbed in small intestine Excess absorption of molybdenum has been shown to produce bony deformities. Deficiency of molybdenum is associated with mouth and oesophageal cancer.
- 46. 46 Summary box - Microminerals
- 47. References 1. K. Park; textbook of preventive and social medicine; 24th edition. 2. Textbook of public health & community medicine 1st edition; AFMC Pune (2009); Ashok K. Jindal, Puja Dudeja. 3. Satyanarayana, U. (2008). Biochemistry. 3rd ed. Kolkata: Books and allied (P) Ltd. 4. Minerals [Internet]. Linus Pauling Institute. 2020 [cited 17 January 2020]. Available from: https://lpi.oregonstate.edu/mic/minerals