(absorption through skin)

Chapter 25

Are You Absorbing the Minerals From Your Diet?

LET’S SAY YOU have designed for yourself the best possible diet. You’ve checked carefully to include enough of each of the important groups of foods—the high-protein meat, fish, poultry, eggs and dairy products; the high-protein seed foods including wholegrain cereals, wheat germ and bran, as well as nuts, beans, soybeans, peas and seeds like sunflower seeds; the vegetables, especially the dark green leafy ones, so rich in B vitamins, vitamin A, C and many minerals, and the fruits that give you vitamin C, vitamin A and potassium in abundance.

You’ve cut out all the unnecessary foods that would otherwise dilute your meals—the ones that contribute nothing but empty calories in the way of sugars and fats. Now can you settle back, secure in the knowledge there’s not one more thing you can do to guarantee good nutrition?

Not quite. There’s still the question of absorption. Are you certain you will absorb all the nutrients you need from such a good diet? There are hazards. Some people suffer from disorders that  make it impossible to absorb much of what they eat. Chronic diarrhea and dysentery bring about the loss of much valuable nutrient as well as water. Celiac disease and related conditions, in which the cereal protein gluten causes trouble, bring about losses of nutrients until a diet that excludes gluten is used.

Another hazard is just getting old. Yes, it seems that, along with all the other disadvantages of growing older, we must contend with reduced ability to absorb as much of the nutrients in our daily meals as we could absorb when we were younger.

Anemia is the disease of iron deficiency, as we know. There is a disease of zinc deficiency called acrodermatitis enteropathica or AE. It’s rare but very disabling and, in the past, usually fatal. Now doctors have discovered they can treat it by giving the trace mineral zinc. Laboratory scientists have measured the amount of zinc in the bodies of patients with AE and compared it to the amount of zinc in the bodies of well volunteers. In every case, the AE patient absorbed only about one-fourth of the zinc he was given. The normal person absorbs about two-thirds of the zinc given.

Scientists are trying to discover how and why this happens. It is not easy. The mechanism of intestinal absorption has been and will continue to-be a major problem of-mineral metabolism.” Doctors know that getting too much iron can be serious, perhaps fatal, to very young children. There are reports in medical literature of children who have eaten a whole bottle of iron pills and become very ill. The reason the iron acts so drastically is not known, says Dr. Strain. It is known that deficiencies of minerals occur most frequently in older folks, presumably because their intestines just do not absorb the minerals as they did when these people were young. There are still gaps in our understanding the changes with age in the absorption and metabolism of iron, zinc and other minerals.

With radioactive tracers of iron and zinc, to determine the amount absorbed by animals of different sexes and ages, by a process called “whole-body counting”, scientists could locate each particle of the dose of iron or zinc they had given the animal, hence discover how much was absorbed and how much had been excreted.

Scientists at the University of Wisconsin fed measured amounts of zinc and iron to laboratory rats, then measured the-amount of each mineral left in the body of the animal. Their studies showed that both iron and zinc were retained and absorbed more by young than by old rats, and larger amounts were absorbed by females than by male rats. In younger animals this sex effect was not very pronounced. But in year-old animals it was obvious that the females retained more. And, interestingly enough, older female rats that had had many offspring retained more of the minerals than young, virgin female rats.

This seems to demonstrate nature’s provision for the young. Young females and even older females that are breeding need more minerals to provide strength and growth for their offspring. Once retired from the breeding program, ‘ the female rats began to absorb less of the minerals.

Iron is the trace mineral that carries oxygen in the blood to all body cells. Without enough of it, weakness and easy fatigue, susceptibility to infections, lassitude and poor mental functioning will result. A recent survey showed that about 15 percent of all Americans examined were short on iron. There is no reason for this except unwise selection of food and neglect of food supplements.

Still another hazard is immobilization due to illness. If you have visited a rest home or nursing home, you have probably been appalled at the number of older people who appear to be completely immobilized. Although conscious and not suffering from any acute disorder, they lie in bed constantly, or they sit-in wheel chairs from which they are apparently never moved )except to return to bed). An important study of this situation was reported in the August, 1975 issue of the Journal of the American Geriatrics Society. Michael B. Miller, M.D., FACP, discussed the eventual effects of such immobility on nursing home patients. They are horrible to contemplate. And they can be reversed by special therapy. There is no need for prolonged inactivity of most patients. And their immobilization makes more work for the nursing staff and doctors, as well as more expense for everyone concerned. Dr. Miller calls these sad effects of immobilization “iatrogenic” (which means caused by doctors) or “nurisgenic” (caused by nurses.)

He tells us first of the great importance of two things in ‘preventing harm to bones—first the mineral calcium in ample amounts every day. There is no indication that our needs for calcium decrease as we age. Indeed, they seem to increase. In women past menopause one early symptom of osteoporosis (or soft bones) is what is known as “dowagers hump”—a not very attractive hump at the back of the neck. Next time you are in church or at a concert, observe the back of the necks of the women sitting in front of you and estimate how many of them are getting too little calcium at meals.

The second most important element in this quite serious disorder that affects older people when they are immobilized is the lack of what doctors call “skeletal stress.” It seems that bones, to be healthy, must be in constant use. This is especially true of those that bear weight—the pelvis, hip bones and leg bones. They were designed by nature to bear weight. As soon as this weight is removed and the individual lies motionless in bed or sits in a wheel chair, those bones begin to disintegrate. If there is an accompanying lack of calcium, osteoporosis is almost certain. Osteoporosis, as we have discussed elsewhere in more detail is the softening of bones as minerals are withdrawn and the bones become unable to bear weight.

Calcium, phosphorus, potassium and other minerals are lost in urine and feces when one is immobile. This makes the situation worse. It is well known that circulatory troubles also increase during bed restfor the simple reason that the valves in the legs do not function properly unless one is up and about. Walking purposefully and briskly is the best way to keep these valves pumping blood along the blood vessels in the leg so that it does not accumulate, become sluggish and clot. The additional loss of so many minerals from bones compounds the health problems.

But prolonged immobilization affects the personality and the social outlook of the bedridden person. Case reports of six elderly women who were put to bed in a nursing home because of broken hips, heart disorders, infections, amputations and so on. After four weeks of immobilization, they had apparently decided they were dying and they began to behave appropriately. They stopped eating and drinking fluids. They stopped talking. They refused to communicate in anyway with nurses or doctors.

If nurses tried to feed them, they spit out the food. Several of them became incontinent of urine and feces. If they were placed in wheelchairs they deliberately caused accidents. When nurses attempted to get them to stand, they went through a series of bizarre movements all calculated to prevent themselves from standing. If they were helped up, their knees collapsed beneath them and they fell to the floor.

Throughout all this there was no measurable evidence of any damage to legs or nerves. True, muscles had wasted and bones were deteriorating because of the prolonged bed-rest, but the personality changes, too, appeared to have no other basis except the fact that they had been confined to bed for so long.

Dr. Miller said, “the syndrome is reversible.” These old-folks can be gotten on their feet. They can be rehabilitated. They can learn to feed themselves once again. They will once again begin to communicate with those around them and  become part of the social life of the establishment. After their rehabilitation they will admit that they thought they were dying and resigned themselves to it. The only reason for this conviction was the total effect upon them of prolonged immobilization.

Dr. Miller related, “In the absence of continuing and direct medical involvement in the progressive rehabilitation of the severely disabled aged patient in whom total disability is exacerbated by the onset of acute illness, the nursing staff in a long-term care facility must assume responsibility for nursing rehabilitation even when such maneuvers require the removal of restraints ordered by physicians. Responsibili­ty for the safety of the patient thus accrues to the nursing staff. Iatrogenic factors in producing the patient’s disability have long been recognized. Nutrigenic factors are now coming to the fore.”

In other words, doctors in general are not always aware of the damage being done to their long-term patients who are immobilized. Or, if they are, they seem not to know what to do about it (if they care). So it is the job of the nurses who are with these patients all day to get them out of bed and out of wheelchairs for their own salvation. Of course, as they become, once again, able to care for themselves, to bathe, clothe and feed themselves, the work of the nurses is greatly decreased.

The usual reason for the original immobilization, which brings all these terrible consequences is, breaking a bone, having a heart attack or some other circulatory disorder or related disease that disables the older person. So the sensible person will do everything possible to avoid such health disasters. For, at any age, prolonged immobilization will bring serious side effects.

The broken bones that accompany falls in older peoples are usually not caused by the fall; the bone just disintegrates and becomes so fragile that it cannot support weight. So it collapses and the individual falls. Plenty of minerals in the diet—chiefly calcium—is the only way to prevent these emergencies.

It helps to have some fat in your digestive tract at the same time as the calcium, so you probably absorb more calcium from whole milk than from skim milk. On the other hand, too much fat causes us to lose calcium.

Vitamin D is essential for the absorption of calcium. We get vitamin D from sunlight in summer and spring, if we are outside part of the day. In winter, especially in northern states, it’s a good idea to take some vitamin D —every week or so, since it is fat-soluble and your body retains it well.

Recently, health food stores have begun to sell chelated minerals. This is a form of the mineral that is easier to absorb than other forms. Chelating agents have been used for many years in animal feed to guarantee that the minerals in the feed are fully absorbed by the animals. There are natural chelates as well. Casein—a protein in milk—and liver extract contain chelates that make it possible for anyone eating milk products or liver to absorb more zinc, for example. Natural and synthetic chelates are used in chick feed so that the young animals make better use of the zinc in the soybean mixtures they are fed.