Unit 9 – Vitamins and Minerals Part 2

9.4 Other Minerals Important to Bone Health

Phosphorus

Phosphorus is the second most abundant mineral in the human body, and 85% of the body’s phosphorus is housed in the skeleton.

Dietary Sources of Phosphorus

Compared to calcium, most people in the U.S. are not at risk for inadequate phosphorus intake. Phosphorus is present in many foods, including meat, fish, dairy products, potatoes, nuts, beans, and whole grains. Phosphorus is also added to soft drinks and many processed foods because it acts as an emulsifying agent, prevents clumping, improves texture and taste, and extends shelf life.

Bar graph showing dietary sources of phosphorus compared with the RDA for adults of 700 mg. Top sources include cheese, yogurt, milk, meat, fish, nuts, potatoes, beans, whole grains, and eggs. Food sources pictured include yogurt, salmon, potatoes, chili with meat and beans.

Figure 9.5. Food sources of phosphorus. Examples of good sources pictured include yogurt, salmon, potatoes, and chili (made with ground beef and kidney beans). Source: NIH Office of Dietary Supplements

Phosphorus Deficiency and Toxicity

Both deficiency and toxicity of phosphorus are rare. The average phosphorus intake in U.S. adults ranges between 1,000 and 1,500 milligrams per day, well above the RDA of 700 milligrams per day. The UL set for phosphorus is 4,000 milligrams per day for adults and 3,000 milligrams per day for people over 70.

Inadequate intake may lead to bone loss, weakness, and loss of appetite. Very high doses of phosphorus taken in supplement form can interfere with calcium regulation and cause calcification, or hardening, of soft tissues, especially the kidneys.2

Magnesium

Approximately 60% of magnesium in the human body is stored in the skeleton, making up about 1% of mineralized bone tissue.

Dietary Sources of Magnesium

Magnesium is part of the green pigment, chlorophyll, which is vital for photosynthesis in plants; therefore, green leafy vegetables are good dietary sources of magnesium. Magnesium is also found in high concentrations in nuts, whole grains, legumes, potatoes, dairy products, fish, and meats. However, processed grains lose most of the natural magnesium. Most foods high in fiber are good sources of magnesium, and it is added to some fortified foods, such as breakfast cereal. Additionally, chocolate, coffee, and hard water contain a good amount of magnesium.

Bar graph showing dietary sources of magnesium compared with the RDA of 310 mg for women aged 19-30 and 400 mg for men aged 19-30. Top sources include nuts, leafy greens, soybeans and soymilk, beans, whole grains, potatoes, banana, milk, and fish. Food sources pictured include almonds, black beans, brown rice, edamame, and potatoes.

Figure 9.6. Dietary sources of magnesium. Examples of good sources pictured include almonds, black beans, brown rice, edamame, and potatoes. Source: NIH Office of Dietary Supplements

Magnesium Deficiency and Toxicity

Most people in the U.S. do not meet the RDA for magnesium, and studies indicate that consuming adequate magnesium may improve health. For example, people with higher dietary intakes of magnesium tend to have lower rates of cardiovascular disease, type 2 diabetes, and osteoporosis, leading some researchers to hypothesize that a low intake of magnesium may increase the risk of these chronic diseases. More studies are needed to determine whether magnesium supplements help prevent these diseases. However, since magnesium is present in many healthful whole foods, improving magnesium intake through the diet may bring multiple benefits.

Obvious magnesium deficiency due to low dietary intake is rare in healthy people because the kidneys can decrease urinary excretion of this mineral when intake is inadequate. People at greater risk of magnesium deficiency include those with type 2 diabetes, gastrointestinal diseases like Crohn’s and celiac, chronic alcoholism, and older adults. A magnesium deficiency can cause decreased appetite, nausea, vomiting, fatigue, and weakness. An extreme deficiency can cause personality changes, muscle cramps, numbness, tingling, seizures, and an abnormal heart rhythm.3

Excessive intake of magnesium from foods is not a risk, as the kidneys can effectively excrete it if it’s in excess. However, people should avoid consuming more than the UL (350 mg) of magnesium from supplements.3  High intakes of magnesium-containing laxatives and antacids may cause diarrhea and cramping.  Excessively high intakes of supplements result in nausea, vomiting, low blood pressure, and cardiovascular changes. 3

Fluoride

Fluoride is a trace mineral needed in very small amounts in the body. It is known mostly as the mineral that combats tooth decay, but it also assists with tooth and bone development and maintenance. Because it isn’t necessary for growth or to sustain life, fluoride is generally not considered an essential mineral. However, fluoride’s role in preventing dental caries (i.e., tooth decay), the most prevalent chronic disease in children and adults, underscores the importance of this mineral in the human diet.4

Fluoride combats tooth decay via three mechanisms:

  • Blocking acid formation by bacteria
  • Preventing demineralization of teeth
  • Enhancing remineralization of destroyed enamel

As a natural mineral, fluoride is present in the soil and water in varying concentrations depending on geographical location. In the 1930s, researchers observed that children living in areas with naturally higher fluoride concentrations in their drinking water had a lower incidence of cavities, leading to the idea that adding fluoride to municipal water supplies could benefit public health. Fluoride was first added to drinking water in 1945 in Grand Rapids, Michigan; now, over 60 percent of the U.S. population consumes drinking water supplemented with fluoride to provide amounts that support dental health. The Centers for Disease Control and Prevention (CDC) has reported that fluoridation of water reduces cavities by 25 percent in children and adults and considers water fluoridation one of the ten great public health achievements in the twentieth century.5

Fluoride’s benefits to mineralized tissues of the teeth are well substantiated, but fluoride also plays an important role in the mineralization of bones, increasing their structural stability. Fluoride is currently being researched as a potential treatment for osteoporosis. The data are inconsistent on whether consuming fluoridated water reduces the incidence of osteoporosis and fracture risk.

Dietary Sources of Fluoride

Fluoride is not widely found in the food supply. In communities with municipal water fluoridation, greater than 70 percent of fluoride intake comes from drinking water. In communities without fluoridated water, intake depends on how much fluoride occurs naturally in the water, but in most areas, natural levels fall below the amounts recommended for cavity prevention.  However, most bottled waters do not have added fluoride.  Other beverages with a high amount of fluoride include teas and grape juice. Solid foods do not generally contain a large amount of fluoride, although this depends on the fluoride level of the soil and water it was grown in and whether it was cooked with fluoridated water. Canned meats and fish that contain bones do contain some fluoride. Other good non-dietary sources are fluoridated toothpaste and dental rinses.

Dietary sources of fluoride include water, tea, shellfish, and fluoridated dental products such as toothpaste.

Figure 9.7. Dietary sources of fluoride include water, tea, shellfish, and fluoridated dental products such as toothpaste.

Fluoride Deficiency and Toxicity

Since it is a nonessential mineral, there is no defined fluoride requirement, but lower levels are associated with higher rates of dental cavities in adults and children. This connection is why so many water supplies are fluoridated.

However, as with all minerals, fluoride can also be toxic if consumed excessively. Acute toxicity symptoms from large fluoride intakes include nausea, vomiting, diarrhea, and convulsions. Chronic toxicity results in an irreversible condition known as fluorosis, characterized by mottling (i.e., white speckling) and pitting of the teeth (see Figure 9.10). Fluorosis is primarily a risk in children because mineralization of permanent teeth has typically occurred by age 8.6

On the left is a close-up image of teeth with a mild case of fluorosis with small white spots forming on the teeth. A picture on the right shows a severe case of fluorosis in a close-up image of front teeth with significant white speckling, discoloration, and pitting.

Figure 9.8. A mild case of fluorosis (left) vs. a severe case of fluorosis (right).

 

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Introduction to Nutrition and Wellness Copyright © 2022 by Janet Colson; Sandra Poirier; and Yvonne Dadson is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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