MINERALS
Monica Adhikari*
Sr Dietician, Great Ormond Street Hospital, London*
Just as vitamins are necessary for maintaining various body functions, similarly, minreals and trace elements are required in small amounts for growth and maintenance of health. Various minerals that are required in human body are:
- Calcium
- Carbon
- Chromium
- Cobalt
- Copper
- Fluorine
- Iodine
- Iron
- Magnesium
- Manganese
- Molybdenum
- Selenium
- Silicon
- Sodium
- Phosphorus
- Potassium
- Zinc

Each trace element leads to poisoning if the dose exceeds and leads to deficiency if the intake is less than requirement. These trace elements are also known as micronutrients. The most important ones are discussed here.
Zinc
Zinc deficiency was first described in the Middle East. Zinc deficiency is commonly seen in conditions such as chronic diarrhea, nephrotic syndrome, cirrhosis, with chelators as in Thalassemia, patients on total parenteral nutrition (TPN), burns and hemolytic anemia. Zinc deficiency can also occur due to eating a predominantly cereal diet or when body requirements are increased as in pregnant women. Zinc in the body can decrease in patients eating mud and clay (pica).

Clinical features of zinc deficiency: Early features of zinc deficiency include loss of appetite, impaired taste and poor healing of wounds. It can also lead to anemia, night blindness, enlargement of liver, loss of hair and tendency towards infection due to impaired immunity. In older boys, impotency may be seen. Zinc deficiency in pregnant women can lead to growth retardation in the baby.

The classical presentation of zinc deficiency is "acrodermatitis enteropathica". This is a genetic disease due to failure to absorb zinc from the intestines. It leads to loss of hair, poor appetite, diarrhea and typical skin ulcerations over the buttocks and genitals.

Diagnosis can be established by measuring zinc levels in blood and urine.

Treatment: Patients with zinc deficiency should eat a diet rich in zinc such as meat, eggs, nuts, cheese, and grains. Zinc can also be applied as a cream over ulcers, wounds, burns and pimples to fasten healing. Zinc can be given in the dose of 20-40 mg/day for treatment of acrodermatitis enteropathica. Zinc is also recommended in the treatment of persistent diarrhea and Wilson's disease (a genetic problem that leads to accumulation of copper in liver and brain. Zinc helps to excrete this extra copper in the urine).

Zinc toxicity: Zinc toxicity can lead to nausea, vomiting, diarrhea, anemia, and neurological problems. It occurs due to food cooked in galvanized utensils.

Recommended Daily Allowance (RDA)
0 - 1 year - 5 mg
1-10 years - 10 mg
> 10 years - 15 mg
Copper
Copper is a part of several enzymes in the body. It is an antioxidant and plays an important part in the utilization of iron and formation of red blood cells. Copper deficiency is extremely rare and may occur in formula-fed premature babies. Copper deficiency leads to anemia, recurrent diarrhea and bone problems. Copper deficiency can also occur in a genetic disease such as Menke's disease (leads to hair and brain involvement).

Excess of copper in the body can occur when milk boiled and stored in brass utensils is consumed. It leads to a liver problem such as Indian Childhood Cirrhosis (ICC). Copper excess can also occur in a genetic disorder - Wilson's disease (characterized by liver, eye and brain problems). Diagnosis of copper deficiency can be established by measuring the blood copper levels. Copper excess can be determined by measuring the copper content in the organ that is involved.

Sources of Copper: Oysters, fish, whole grains, nuts, legumes, milk boiled and stored in brass utensils.

Recommended Daily Allowance (RDA): 0.05 - 0.1 mg/kg.
Magnesium
Magnesium is a part of bone and teeth and helps to maintain normal function of muscles and nerves. It has been used in treatment of asthma and persistent pulmonary hypertension (PPHN) in newborns. Deficiency of magnesium leads to spasm of the muscles (tetany). Deficiency can occur in malnutrition, diabetes, chronic kidney disease and in patients with pancreatic problem. Magnesium deficiency can be diagnosed by measuring the magnesium levels in the blood.

Magnesium excess can occur in newborns born to mothers who had received magnesium in pregnancy.

Sources: Cereals, legumes, nuts, milk, meat.

Recommended Daily Allowance: 40-340 mg.
Selenium
It is part of the enzyme system of the body. Deficiency of selenium leads to heart (cardiomyopathy) and muscle involvement (myopathy). It is particularly seen in Keshan province in China where the soil is deficient in selenium. Excess of selenium causes alopecia, abnormal nails, garlic odor to the breath and fatigue.

Sources of selenium: Vegetables, meat, water.

Recommended Daily Allowance (RDA)
< 6 months of age - 10 µg
6-12 months of age - 15 µg
1-6 years of age - 20 µg
7-10 years of age - 30 µg
> 11 years of age - 50-75 µg
Other Minerals
Minerals are needed for growth and maintenance of body structures. They also help to maintain digestive juices and the fluids found in and around cells.

The minerals the body needs in large amounts include calcium, chlorine, magnesium, phosphorus, potassium, sodium, and sulfur.

Other minerals, called trace elements, are needed in much smaller amounts. Trace elements include iron, copper, fluorine, iodine, selenium, zinc, chromium, cobalt, manganese, and molybdenum.
Mineral
Health benefits
Deficiency
Best sources
Excess
Calcium
Is vital for building strong bones and teeth. The time to build strong bones is during childhood and teen years.
Important for muscle function.
Weak bones are susceptible to condition called osteoporosis, which causes bones to break easily
Milk
Yoghurts(dahi)
Cheese
Paneer (cottage cheese)
The kidneys help to control calcium levels. Healthy kidneys can increase calcium excretion almost fivefold to maintain normal concentrations in the body. Hypercalcemia can occur when the concentration of calcium overwhelms the ability of the kidneys to maintain balance.
Iron
Helps red blood cells carry oxygen to all parts of the body.
Helps in energy production.
Symptoms of iron deficiency anemia include weakness and fatigue, lightheadedness and shortness of breath.
Red meat
Fish
Chicken
Lentils
Beans
Leafy vegetables
Raisins
Some of the cereals and flours are fortified with iron.
Signs of iron overload may be seen after as few as 10 red blood cell transfusions, making iron overload a common secondary disease among transfusion-dependent patients.
A patient with chronic severe anemia's caused by thalassemia ,sickle cell disease , and myelodysplastic syndromes are at greatest risk.
Magnesium
Helps muscles and nerves to function, steadies the heart rhythm and keeps bones strong.
It also helps the body to create energy and make protein
Whole grains
Nuts
Leafy vegetables
Potatoes
Beans
Bananas
Shrimps
Common conditions such as mitral valve prolapse,migraines, attention deficit disorder, fibromyalgia,asthma and allergies have all been linked to a Mg deficiency
Not known.
 
Phosphorous
Helps in healthy bones and teeth.
It also helps body to make energy.
It is apart of every cell membrane, every cell in the body needs phosphorous to function normally.
is found in most foods but the best sources are dairy products,
Meat, Fish
Symptoms varying from painful bones, irregular breathing, fatigue, anxiety, numbness, skin sensitivity and changes in body weight.
A ratio of 2:1 in the diet between phosphorus and calcium can cause low blood calcium levels.
Ingesting dosages of phosphorus exceeding 3 to 4 grams may be harmful as it can interfere with calcium absorption, such as the high level in fizzy soda drinks.
Potassium
Helps in muscles and nervous system function.
It also helps the body to maintain the balance of water in the blood and body tissues.
Potatoes (with skin)
Leafy vegetables
Citrus Fruitse.g. oranges,lemon.
Bananas
Dried fruits
Peas
The kidneys excrete any excesses, but deficiencies are seldom found in people on normal diets, although most people could look at increasing their potassium intake. A deficiency may result in fatigue, cramping legs, muscle weakness, slow reflexes,acne, dry skin, mood changes, and irregular heartbeat.
Excessive potassium can be toxic and will affect your heart, but is mainly a problem when you suffer from a problem such as kidney failure.
Zinc
Important for strong immunity.
Wound healing. (tissue repair and growth), Essential for cell reproduction, normalgrowth and developmentin children.
Chicken
Seafood
Nuts
Dried beans
Milk
There is a shortage of zinc in many people's diet, since zinc is destroyed in the milling process and is also lost in cooking. A deficiency will result in an under-performing immune system, open to infections,allergies, night blindness, loss of smell, falling hair, white spots under finger nails, skin problems, sleep disturbances etc.
Larger amounts may result in nausea,diarrhea, dizziness, drowsiness and hallucinations.
Sodium
Essential for maintaining normal blood pressure and balance of body fluids and for transmitting nerve signals
Table salt, vegetables
animal foods
some bottled waters
A deficiency is rare, but can easily happen with diarrhea, vomiting or excessive sweating, and a shortage may lead to nausea, dizziness, poor concentration and muscle weakness.
Excessive sodium may cause high blood pressure, which may lead to a host of health problems. Excessive long-term use of sodium may also cause a loss of calcium from your body.

The best way to get the vitamins and minerals you need is by eating a varied, balanced diet, rich in fruits, vegetables, and whole grains.
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.