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Bone Health (introduction (Importance (Structural support (attached to…

- - - - Primary
        
        Bone formation and maintenance
        
        Offers strength and rigidity through hydroxyapatite crystals
      - Secondary
        
        Blood and Tissue Phosphorus
        
        Fluid Balance
    - - high availability in diet
      - Enhanced by Vitamin D
      - Very effective absorption
    - - Unlikely due to
        
        High availability in diet
    - - Animal Protein Foods
      - Milk and Milk Products
      - Legumes, Cereal, Bran, Nuts
  - - - primary role
        
        immune function
        
        maturity of immune cells
        
        regulation of blood Ca & bone mineralization
      - other important role
        
        mitigating risk for MS, T1D, T2D
        
        nerve function
    - - intestines
        
        increase Ca absorption
      - bone
        
        activate osteoclast cells to release Ca from bone into blood
      - kidneys
        
        decreases Ca excretion
    - - fat soluble
    - - children
        
        consequence = rickets
        
        clinical signs
        
        improper mineralization and shaping of bones
        
        “bowed legs”, “knock-knees”
      - adults
        
        consequence = osteomalacia
        
        osteoid = protein matrix secreted by osteoblasts into which minerals are deposited to form bone
        
        clinical signs
        
        progressive weakness with increasing pain in lower back and legs
    - - most likely cause
        
        supplement use
      - health consequence
        
        hypercalcemia
        
        calcium deposits into soft tissue
        
        high blood calcium levels
    - - fortified plant-based milks
      - other fortified products
      - dark green vegetables
      - tofu
    - - advisable if
        
        adults over age 50 (take 400 IU of vitamin D daily)
      - be cautious of fish oil
    - - SPF ≥ 8 blocks synthesis
      - pollution
      - age
      - latitude
      - skin colour
      - time of day
  - - - Bone and Teeth
      - Blood and Tissue Magnesium
      - Hypertension
    - - rarely seen in healthy individuals
      - see increased losses with
        
        prolonged: vomiting, diarrhea, use of diuretics
        
        renal disease, alcoholism
        
        heavy perspiration over a period of time
      - develops slowly
      - symptoms
        
        hypertension
        
        weakness, disorientation, irritability
        
        irregular heart beat
        
        tetany at extreme low levels of Mg
    - - no known toxicity
    - - halibut
      - green leafy vegetables
      - milk, yogurt
  - - - Ca mineralization of bone
      - blood clotting
    - - infants
        
        sterile gut = no vitamin K synthesis
        
        low levels in breast milk
        
        low levels of gut bacteria for vitamin K synthesis
      - adults
        
        use of antibiotics
        
        fat malabsorption condtions
        
        excessive intake of vitamin E
    - - low risk
      - can hinder effects of anti-coagulant drugs
      - Symptoms
        
        RBC hemolysis
        
        jaundice
        
        brain damage
    - - green leafy vegetables
      - milk
      - eggs
      - Non-food source
        
        bacterial synthesis in large intestine
    - - resistant to losses during cooking
  - - - bone & teeth mineralization
    - - before teeth erupt through gums
      - during bone & teeth development
    - - people in areas with low fluoride in water supply
        
        increased risk of dental caries
        
        inability to chew properly and consume a variety of foods
    - - fluorosis
        
        white specks or brown streaks on teeth
        
        teeth more resistant to decay
        
        abnormal hardening of skeleton
        
        stiffness & pain in joints
        
        brittle bones
    - - seafood, shellfish
      - fish
      - seaweed
  - - - Primary
        
        Bone formation and maintenance
        
        through
        
        Hydroxyapatite crystals
      - Secondary
        
        Blood clotting
        
        Nerve transmission and muscle contraction
    - - Enhanced
        
        acidic environment
        
        vitamin D
        
        periods of growth
        
        lactose
        
        estrogen
      - Decreased
        
        high fibre diet
        
        phytic and oxalic acid
        
        high fat diet
        
        supplement use
        
        menopause
        
        old age
        
        polyphenols
    - - Osteoporosis
        
        Seniors at greatest risk
        
        Consequences
        
        Increased risk of fractures
        
        due to
        
        Inactive Osteoblasts (build bone)
        
        Active Osteoclasts (breakdown bone)
        
        1 in 4 Canadian Women (over age of 50)
        
        1 in 8 Canadian Men (over age of 50)
        
        Risk Factors
        
        Age/Gender/Hormones
        
        Genetics/Race
        
        Physical Activity
        
        Low Body Weight
        
        Smoking and Alcohol
        
        Associated Nutrients
        
        Vitamin D deficiency
        
        Decreases Calcium Absorption
        
        Fluoride
        
        Increases bone crystal strength
        
        Excess Sodium, Caffeine or Protein
        
        Pull Calcium into Urine
        
        Reducing Risk of Fractures
        
        Regular Menstruation and Ovulation
        
        Healthy Lifestyle
        
        examples
        
        Limited Sun Exposure
        
        Adequate Calcium Intake
        
        Avoid Alcohol and Smoking
        
        Moderate Exercise
      - Supplements
        
        Safe
        
        but avoid
        
        Unrefined Oyster Shell
        
        Dolomite
        
        Coral
        
        Bone Meal
        
        advisable if
        
        inadequate intake
        
        low intake of Iron
    - - Milk
      - Some Leafy Greens
    - - health effects
        
        Hypercalcemia
        
        Hyperparathyroidism
- - - - pDEXA
        
        non-invasive, painless; screening only, no diagnostic use
        
        x-rays measure bone density in heel, wrist, finger
      - Ultrasound
        
        sound waves used to measure bone density
        
        non-invasive, painless; screening only, no diagnostic use
        
        often use the heel
      - DEXA
        
        generate a “T-score” from the comparison
        
        scans entire body or specific areas
        
        non-invasive, painless, relatively quick
  - - - parathyroid hormone
        
        stimulates action of
        
        calcitriol
        
        enhances Ca absorption in intestines
        
        stimulates Ca reabsorption in kidneys
        
        stimulate osteoclasts to break down bone
        
        release Ca in blood
    - - calcitonin
        
        inhibits
        
        osteoclast to break down bone
        
        prevents
        
        prevents Ca reabsorption in kidneys
        
        limits Ca absorption in intestines
  - - - attached to muscles
      - protect organs
      - chewing ability