0:16 Welcome you all to the week 8 video on macrominerals, micro minerals, water and electrolyte. So this is going to be the last week video and we are going to concentrate now on the calcium, phosphorus, magnesium, sodium and potassium. At the end of this session, the student will be able to understand the definition, functions, mechanism, dietary requirements, ICMR, RDA which is uh uh recommended dietary allowances, bioavailability, toxicity and food sources of calcium, phosphorus and the critical interependent roles in bone mineralization, energy metabolism and cellular signaling. Similarly with regard to magnesium, sodium and potassium the same components
1:02 will be explored along with their essential roles in enzyme activation, fluid balance, nerve conduction and muscle function. So what are macro minerals? We have covered about vitamins, major nutrients like energy, protein, carbohydrate, fat and these macro minerals are also called as the major minerals which are inorganic elements required by the human body in amounts greater than 100 mg per day which is 100 mg per day. They constitute approximately 4 percentage of the total body weight and are essential for structural integrity, biochemical reactions, fluid balance, nerve transmission and muscle contraction.
1:49 So uh as discussed in the previous slide, the macro minerals are required in amounts greater than 100 mg per day and they are distinguished. This is how they are distinguished from the trace minerals. They are also essential for structural regulatory and biochemical functions. They are tightly regulated by hormones such as uh parathyroid hormone, calcetonin, aldoststerone and antidiuretic hormone. The electrolyte balance between sodium, potassium and calcium, magnesium is critical for cellular homeostasis. The first macro mineral that we would be uh talking about is calcium. According to World Health Organization, calcium is an
2:35 essential macro mineral and the most abandoned mineral in the human body. It's critical for the development and maintenance of bones and the teeth and the normal muscle function, nerve transmission and also in the blood clotting. There are uh various ensematic processes that also involve uh calcium for for its functioning. Adequate calcium intake throughout life is essential to prevent osteoporosis and related fractures. If you see the total body content of calcium is uh about 1,00 to 1,200 g for adults whereas about 99%age of this particular amount is uh present in the bones and the teeth as hydroxy appatite
3:21 whereas 1% is uh present in blood and soft tissues. The serum calcium levels are uh basically from this particular range which is 8.5 to 10.5 mg per deciliter which is tightly regulated and there are various forms in blood uh which is 45%age of ionized calcium which is active and 45%age of protein bound albamin and 10%age is complexed with citrate and phosphate. When we talk about hormonal regulation, parathyroid hormone raises blood calcium levels and calcetonin will lower the blood calcium and calc which is the active form of vitamin D will enhance its absorption.
4:06 The bone reservoir uh uh is the major uh aspect of calcium because it remodels it's being continuously remodeled by osteoblast which is the for bone forming cells and osteoclast which is the uh breaking cells. When we talk about the functions of calcium there are lot of functions that are uh regarded with calcium always classified under calcium. The first one is bone and teeth formation. Calcium phosphate is also termed as hydroxy appatite forms the mineral matrix of bone which is providing the rigidity and strength. 99%age of body calcium is involved in bone and teeth formation.
4:53 Similarly, muscle contraction is something that always calcium binds with troponency exposing the meiosin binding sites on actin and crossbridge formation uh and also involved in muscle contraction. They are released from saroplasmic reticulum by action potential. Calcium triggers neurotransmitter release at the synaptic terminals which are essential for the nerve impulse transmission. Calcium is also involved in the blood coagulation especially in factor 4 which is essential for the activation of clotting factors like two 7 9 and 10. Without calcium the blood cannot clot or coagulate.
5:39 There are lot more functions of calcium which includes cardiac function where uh the calcium will help in regulate the cardiac muscle contraction and rhythm. uh when there is a low calcium levels in the body which is also called as hypocalcemia they may cause prolonged QT interval and the cell signaling uh aspect calcium forms as a second messenger in cell signaling activating the protein kinosis and calm modulin and phospholipases enzyme activation uh this forms as a co-actor for multiple enzyme lipase ATPs and phospholipase the hormone bas basically includes uh insulin, parathyroid hormone and other hormones are being uh uh secreted with the help
6:26 of calcium via the exocytosis. So this includes a lot of functions with regard to calcium in our body and coming to the mechanism uh calcium is basically involved in three main organs along with their activity. One is the bone and the second is the kidney and the third is the intestine. When there is a blood calcium drop in our body which is called as a hypocalcemia, the parathyroid gland detects the low calcium levels in our body and then it releases PTH which is the parathyroid hormone and they simultaneously uh acts in three ways. One is in the bone where in the bone PTH which is a parathyroid hormone activates
7:13 the osteoclast into bone resorption and calcium is getting released into the blood. That's the first uh action in the kidneys. The pythroidid hormone increases the calcium resorption in the distal tubil where the less calcium is lost in the urine. And similarly this PTH is activating the alpha one alpha hydrolace hydroxilase to form the active form of vitamin D which is a calcol. So the in the kidney there are two uh actions that is taking place in the intestine via the calcol which is the active form of vitamin D. The calcitriol upregulates the calbinding D which enhances the calcium absorption from the intestine. So these three are very
8:00 important when it comes to low calcium level. So this uh activity will increase the calcium levels or bring the calcium levels into normal uh condition when there is a blood calcium high in the body. Uh these are the things that happens. One is uh hypercalcemia where the thyroid C cells release calcetonin that will inhibit the osteoclast which will reduce the bone resorption and calcium will therefore return to its normal levels. Under muscle contraction mechanism, there is a different mechanism that happens in the muscles where action potential will always release the calcium from the cycloplasmic reticulum which binds the
8:46 tropon and C. Tropommyioin moves and also meiosin binds the actin. Crossbridge cycling and contraction takes place whereby calcium is pumped back and hence the relaxation takes place. Always the contraction and relaxation is happening with these kind of mechanisms which is where calcium plays an very important role. When we talk about the requirements of calcium, calcium uh is required in good amounts for both adult men and women uh at 400 mg per day. For pregnancy and lactation it is 1,000 mg per day which is roughly about 1 g per day. For infants it is 500 mg per day. And for
9:33 children it is uh from 1 to 9 years it is 400. 10 to 15 years it is 600. 16 to 18 years it is 500 mg per day. All are having very important functions with regard to the bone development and uh muscle contraction and so on which was discussed earlier. So this particular slides uh grabs attention because this is called as the homeostasis of calcium where we can see uh the bone is involved and there is the intestine and the kidney and the parathyroid hormone is gland is involved. This is nothing but the same thing which was discussed earlier. When there is a lower level of calcium
10:19 there is a resorption of calcium which happens here. So parathyroid hormone is released and the blood calcium and phosphorus levels are being maintained and there is an activation of uh calcitriol which is active vitamin D and again it goes to the um bone for uh increasing levels of uh calcium. This mechanism is very much important for balancing the systems throughout the body. Uh therefore it maintains an overall state of dynamic equilibrium or homeostasis with life. So when we talk about the bioavailability of calcium, the absorption of minerals is generally less efficient than that of the vitamins and macronutrients. Not all the food that uh
11:06 we consume uh with regard to the intake of minerals is necessarily available to the body. That means the term bioavailability refers to the degree to which the body uses a particular nutrient which depends on many factors that may influence its absorption, excretion balance or its deposition, mobilization balance in body tissues and that's how it is. So not all are getting absorbed in our body. So we have to see to that the rich sources are always supplemented that gets better absorbed. When we talk about the toxicity hypercalcemia uh is higher levels of calcium in the body
11:52 which accounts to a lot of uh symptoms. Uh when it comes to hypercalcemia it it can be acute. So it could cause nausea, vomiting constipation polyurea confusion. Uh and uh when there is more calcium in our body, it may lead to kidney stones and uh sometimes even we have some psychic wounds also. Uh milk calculate syndrome is one particular syndrome where you can find there is an excess of calcium and antacid intake and that leads to metabolic alkosis and kidney damage as well. Kidney stones could be because of calcium oxilate stones which is the most common kidney stone type. Vascular calcification includes that
12:37 excess calcium deposits in arteries and soft tissues. Sometimes high calcium intake would lead to constipation because of excess uh calcium supplementation in the body. Uh impaired mineral absorption is also possible. When there is more of calcium in the body, it would lead to uh inhibit the absorption of iron, zinc and magnesium. And uh there may be some cardiac problems also that we could see with regard to excess calcium uh levels in the body where QT interval is shortened and the cardiac arhythmias are also seen. So food sources uh as such if we see with regard to the calcium ragi forms
13:23 the highest uh under vegetarian sources and even cesium seeds or cesium seeds uh is having 975 mg per 100 g and drumstick leaves is a very good source of calcium which amounts to 440 uh mg per day per 100 g. Amaran leaves has about 397 mg per 100 gram. Sardins with bones uh contribute to about 382 mg per 100 g. Almonds uh about 264 and tofu also has good amount of calcium which is about 350 mg per 100 g. And milk and curd all comes with 120 and 140 mg per 100 g.
14:11 Coming to the stability of calcium. Uh calcium is a mineral which is not destroyed by heat, light or oxygen during cooking. Uh cooking reduces the oxalate content in vegetables improving the calcium availability mostly from spinach and other oxalate rich greens. Uh when it comes to fermentation of cereals and legumes, they reduce the phitate content significantly improving the calcium bioavailability. Soaking and sprouting of legumes and grains reduces the phitates which uh is always in the recommended practice for uh being used in the Indian cooking to improve the calcium absorption. So when we talk about calcium, calcium
14:57 has been a very important uh mineral uh which is the major macro mineral which is very much needed uh more than 100 mg per day is needed for our body. So that becomes a major contribution of calcium as a part of macro mineral. Next we move on to phosphorus. According to the World Health Organization, phosphorus is an essential macro mineral present in every cell of the body playing fundamental roles in bones and teeth formation, energy metabolism as a component of adinine triphosphate, cell membrane structure with regard to phospholipids, uh DNA and RNA synthesis, acid base balance and enzyme activation.
15:49 uh total body content of fa phosphorus is amounting to 600 to 700 grams in adults which is about 85%age of bones uh and teeth as hydroxy appetite 14% in soft tissues and 1 percentage in blood. Blood level serum phosphorus is about 2.5 to 4.5 mg per deciliter. Chemical forms include inorganic phosphate, organic phosphate where ATP, phospholipids, DNA, RNA and phosphoproins are being majorly u involved. Calcium phosphorus ratio uh the ideal dietary ratio is 1 is to1 to 2 is to1 which helps in the uh prevention
16:34 of the imbalance of calcium phosphorus thereby impairing the bone metabolism. Hormonal regulation uh uh is a major contribution of phosphorus again next to the calcium where parathyroid hormone decreases the renal phosphate reabsorption by reducing the phosphate reabsorption about vitamin D enhances the intestinal absorption of phosphorus similar to calcium even phosphorus is involved in bone and teeth mineralization energy metabolic ISM a cell membrane structure DNA and RNA synthesis. So starting with the bone and teeth mineralization calcium phosphate
17:20 which is the hydroxy appatite forms the structural mineral matrix of bones and teeth about 85%age of body phosphorus is stored in bones and teeth. Uh similarly in as an energy metabolism phosphate is a key component of ATP and that's the universal energy currency for the cells. When it comes to cell membrane structure phospholipids such as the phosphatidyl colon and phospatidyl ethanol amamine form the lipid billayer of all the cell membranes. DNA and RNA synthesis is also uh important when it comes to phosphorus because the phosphodiester bonds connect the nucleotides in the backbone of DNA and RNA which is essential for genetic
18:07 information storage and transfer. Coming to the enzyme regulation uh protein phosphorulation and defphosphorilation are the major mechanisms for the activation and cellular signaling which again depends on the calcium and phosphorus. So there are lot more functions with regard to phosphorus which is nothing but uh acid base balance. The phosphate buffer system helps to maintain the blood and intracellular pH balance. Oxygen transport uh which is the 23 bisphosphoglycerate in red blood cells regulates the hemoglobin's affinity for oxygen and promotes oxygen release to the tissues. B vitamin activation is
18:55 being uh very much uh done using phosphorulation because they activate several B vitamins especially TPP which is the thamin pyroof phosphate FMN which is flavven monucleotide all that is being uh activated because of the phosphorilation all these phosphorilation reactions require phosphate phosphor creatinin stores energy and rapidly regenerate ATP in muscles during the intense physical activity. So coming to the mechanism of phosphorus, dietary phosphorus gets absorbed in the small intestine and they enter the cellular metabolism through ATP synthesis through protein
19:40 phosphorulation and bone mineralization and uh RP BPG in the um oxygen delivery. So all that has been explained in the previous slide. This is a pictorial depiction. Coming to the bioavailability of phosphorus, phosphorus absorption form mixed is been very much important when it comes to the mix from the mixer diet. It is approximately 55 to 70%age while absorption from animal-based foods may reach up to 90%age due to higher bioavailability. Absorption mainly occurs in the small intestine through active transport via sodium phosphate coransporters passive diffusion mechanisms. Animal
20:26 food sources such as meat, milk, dairy products, fish and eggs contain phosphorus in highly absorbable forms. Plant sources have lower phosphorus bioavailability because nearly 50%age of phosphorus exist as phitates or phitic acid which humans cannot efficiently digest due to the absence of phitase enzyme phitate phitase enzyme available phosphate. So when it comes to the vitamin D, vitamin D enhances the intestinal phosphate absorption by increasing the uh expression of sodium phosphate coransporters in the intestinal lining. Phosphate acts as a major inhibitor of phosphorus absorption
21:12 in cereals, legumes and pulses. The traditional food processing methods such as soaking, sprouting, fermentation helps in uh reducing the phitate levels and improve the phosphorus bioavailability. In the Indian dietary context, foods rich in phitates such as rice, wheat and legumes show lower phosphorus availability whereas fermented foods like idli and dosa will significantly improve the phosphorus absorption by reducing the phytate content. So uh coming to the toxicity which is the hyperphospatmia. Uh hypocalcemia will always lead to excess of phosphorus leading to the calcium phosphate complex that lowers the calcium thereby leading
22:00 to tetany and muscle spasms. uh bone disorption which is uh present in u because of high phosphorus calcium ratio uh leads to the secondary hyper parathyroidism thereby leading to increased parathyroid hormone secretion leading to bone resorption and osteoporosis. Even vascular calcification takes place when there is excess phosphate deposits in the arteries are major concerns in chronic kidney disease. uh chronic kidney disease uh condition the kidneys cannot excrete excess phosphorus because of the renal failure. Thereby it leads to dangerous hyperphospatmia. Under soft tissues if there is excess phosphate and calcium in the gets
22:48 deposited in the heart, lungs and tissues. That's where the hyperphospatimmia tox is seen in different parts of the body. The food sources of calcium include more or less like calc phosphorus is more or less like calcium where you can see that milk is having about 950 uh mg. Paneer has about 520 mg per 100 g. Chicken cooked has about 220 mg per 100 g. Fish salmon has about 310 mg. Lentils cooked about 180 mg per 100 g. Ground nuts having 376 mg per 100 g. Whole wheat about 288 mg. Eggs contain about 198 mg per 100 g. So
23:34 coming to the stability, phosphorus as a mineral is not destroyed by heat, light or cooking. However, phitate bound phosphorus in plants is released by fermentation, soaking and sprouting. Traditional Indian Indian practices that significantly improve phosphorus bioavailability is also seen.
