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Bone Health (maintained by (trace minerals (such as (fluoride (toxicity…

- - - - fluoride
        
        is
        
        ubiquitous
        
        found in
        
        soils, water supplies, plant foods, animal foods
        
        30-80% absorbed
        
        found in
        
        food sources
        
        such as
        
        Brewed tea, water, seafood, seaweed, shellfish, fish
        
        non-food sources
        
        such as
        
        chewing gum, mouthwash, toothpaste
        
        functions in
        
        bone and teeth mineralization
        
        by replacing
        
        hydroxyl group in hydroxyapatite, creating a stronger crystal called fluorapatite
        
        which is
        
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        is
        
        Best taken before teeth erupt gums
        
        maintained by
        
        Topical treatment that helps protect against dental caries
        
        an antimicrobial that helps fill in surface microlesions
        
        deficiency
        
        caused by
        
        Low levels in water supply, leading to increased risk of dental caries
        
        that contribute to
        
        the ability to chew properly and to consume wide variety of foods
        
        toxicity
        
        has no link to
        
        increased risk of cancer at moderate intakes
        
        Children consuming large amounts of toothpaste are at risk
        
        causes
        
        fluorosis
        
        which are
        
        white specks, mottling, or brown streaks on teeth during teeth development
        
        causes
        
        stiffness and pain in joints
        
        may lead to
        
        osteoporosis
- - - - calcium
        
        blood calcium level
        
        controlled by
        
        calcitonin
        
        inhibits
        
        activation of vitamin D
        
        osteoclasts cells from breaking down bone
        
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        limits
        
        calcium absorption in the intestines
        
        prevents
        
        calcium reabsorption in the kidneys
        
        rising blood calcium signals the thyroid gland to secrete to lower blood calcium levels
        
        parathyroid hormone
        
        stimulates
        
        activation of vitamin D
        
        osteoclasts cells to break down bone
        
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        falling blood calcium signals the parathyroid glands to raise blood calcium levels
        
        Calcitriol (vitamin D)
        
        stimulates
        
        calcium reabsorption in the kidneys
        
        works with
        
        enhances
        
        calcium absorption in the intestines
        
        helps
        
        bone formation and maintenance
        
        by forming
        
        hydroxyapatite which clusters around the PRO matrix (osteoid) of bone
        
        to provide
        
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        nerve transmission and muscle contractions
        
        Low Ca level in muscle cells causes tetany
        
        High Ca level in muscle cells causes rigour
        
        Blood clotting
        
        essential in
        
        synthesis of fibrin
        
        forming
        
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        hypertension
        
        toxicity
        
        causes
        
        Hypercalcemia
        
        causes
        
        high blood (and urinary) calcium levels
        
        calcium deposits into soft tissue (e.g., kidneys, heart, arteries)
        
        irreversible damage to organs
        
        caused by
        
        hyperparathyroidism
        
        which is
        
        overproduction and secretion of parathyroid hormone
        
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        affects
        
        people with kidney disease the most
        
        increase in absorption
        
        from
        
        lactose
        
        by forming
        
        absorbable complex
        
        decrease in absorption
        
        caused by
        
        menopause
        
        due to
        
        low estrogen and old age
        
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        food constituents
        
        high fibre diets
        
        phytic acid
        
        in
        
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        oxalic acid
        
        found in
        
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        high fat intake
        
        found in
        
        food sources
        
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        caused by deficiency in
        
        deficiency
        
        affects
        
        2 million people in Canada (mostly women)
        
        1 in 8 men; 1 in 4 women
        
        greater risk for
        
        People from 30 to 40
        
        leads to
        
        osteoporosis
        
        risk factors
        
        sex hormone (protective of bone) decline with age
        
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        genetics/race
        
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        physical activity
        
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        body weight
        
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        smoking
        
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        alcohol
        
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        calcium nutrition and associated nutrients
        
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        which is
        
        the decrease bone density and increase bone fragility
        
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        supplements
        
        types
        
        tablets, chewable, liquid, effervescent
        
        carbonate, citrate, lactate, phosphate
        
        avoid natural source supplements high in heavy metals
        
        divided doses during day
        
        absorption
        
        30% for all supplements
        
        take calcium carbonate with food
        
        calcium citrate can be taken without food
      - phosphorus
        
        essential for
        
        functions
        
        activating the B vitamin coenzymes
        
        ATP, RNA, DNA
        
        Phospholipid membrane and lipoproteins
        
        Buffer in blood
        
        Fluid balance
        
        provides
        
        intracellular anionic electrolyte
        
        for
        
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        hydroxyapatite
        
        provides
        
        strength and rigidity
        
        to
        
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        deficiency
        
        is
        
        very unlikely with
        varied and well-balanced diet
        
        may see
        
        neuromuscular, skeletal, hematological and renal malfunctioning
        
        increase in absorption
        
        from
        
        vitamin D
        
        plant sources
        
        in form of
        
        phytic acid
        
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        efficient absorption (60-90%)
      - magnesium
        
        excreted through
        
        kidneys
        
        contained in
        
        body - 25g
        
        bones - 60%
        
        muscles - 20%
        
        other tissues - 20%
        
        is
        
        50% absorbed from foods
        
        found in
        
        food souces
        
        such as
        
        plant foods
        
        including
        
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        hard water
        
        animal foods
        
        such as
        
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        Holds central location in chlorophyll molecule
        
        deficiency
        
        sees see increased losses with
        
        heavy perspiration, prolonged vomiting, diarrhea, use of diuretics, renal disease, and alcoholism
        
        symptoms include
        
        irregular heart beat, weakness, disorientation, irritability, hypertension, and tetany
        
        Severe symptoms rarely seen in healthy individuals
        
        BC adults have suboptimal intakes
        
        develops slowly
        
        absorption reduced by high fibre intake
        
        functions in
        
        hypertension
        
        by acting as
        
        vasodilator - protects against high blood pressure
        
        by lowering
        
        rates of heart disease in regions where people drink hard water
        
        bone and teeth
        
        used in
        
        mineral crystal structure of bone - replaces calcium in hydroxyapatite
        
        needed for
        
        the action of vitamin D and production of parathyroid hormone
        
        by helping to
        
        prevent dental caries by holding calcium in enamel
        
        normal immune function
        
        blood and tissue
        
        by stabilizing
        
        high energy phosphate bonds (ATP)
        
        needed for
        
        neurotransmitter activity
        
        required for
        
        enzyme systems
        
        by inhibiting
        
        muscle contractions and blood clotting
        
        indirectly affects balance of
        
        high intake interferes with absorption of
- - - - mineral crystal: hydroxyapatite (Ca₁₀[PO₄³¯]₆[OH]₂)
        
        provides
        
        strength
      - nerves, cartilage, connective tissues
      - mineral crystals in a protein (collagen) matrix known as osteoid
      - RBC, WBC, and platelets
        
        manufactured in
        
        bone marrow
    - - structural support
        
        allows
        
        chewing
        
        attaches to
        
        muscles by tendons
        
        protects
        
        organs
    - - inorganic mineral crystals
        
        that provides
        
        strength and rigidity
      - organic matter
        
        such as
        
        protein matrix (collagen)
        
        provides
        
        flexibility
        
        connective tissues
        
        cartilage
        
        nerves
    - - DEXA- dual energy X-ray absorptiometry
        
        Very low x-ray energy scan
        
        Non-invasive, painless, relatively quick (~20 mins)
        
        Scans entire body or specific areas
        
        "T-score"
        
        indicates
        
        bone mass and the risk of fracture
      - PDEXA-peripheral dual energy x-ray absorptiometry
        
        noninvasive, painless
        
        screening only, no diagnostic use
        
        measures
        
        bone density in heel, wrist, finger
      - ultrasound
        
        noninvasive, painless
        
        uses
        
        sound waves
        
        to measure
        
        bone density
        
        uses
        
        the heel
    - - trabecular bone
        
        is
        
        lace-like, not as dense as cortical bone
        
        sensitive to hormone
        
        that regulate
        
        deposits and withdrawals of calcium into and from bone
        
        very dynamic
        
        makes up
        
        ~20% of the entire skeleton
        
        composed of
        
        ends of long bones, spinal vertebrae, pelvis, ribs, inside flat bones
      - cortical bone
        
        is
        
        ivory-like, very dense
        
        strong
        
        has
        
        slow turnover
        
        makes up
        
        ~80% of the entire skeleton
        
        composed of
        
        most of small bone and outer surface of long bones
    - - nutrients (Ca, P, Mg, F, vitamin D & K), hormone, genetics, and environmental factors
    - - growth (size and length
      - modelling (shape)
      - remodelling (density)
        
        involves
        
        reabsorption and formation
    - - metabolically dynamic
        
        osteoblast cells (build)
        
        osteoclast cells (crumble)
- - - - vitamin K
        
        are
        
        quinones
        
        phylloquinone - plant
        
        menaquinone - animal
        
        is
        
        40-80% absorbed
        
        stored in
        
        liver and adipose tissue
        
        antibiotic use increases dietary need
        
        found in
        
        non-food souces
        
        such as
        
        endogenous - bacterial synthesis in large intestine
        
        food sources
        
        such as
        
        Green leafy vegetables (kale, spinach), peas, broccoli, green beans
        
        Liver, egg, milk
        
        is
        
        Resistant to losses in cooking
        
        widely distributed
        
        Abundant in diet
        
        functions in
        
        calcium mineralization of bone
        
        needed for
        
        osteoblasts to produce osteocalcin, a calcium-binding hormone made in osteoblasts that promotes calcium mineralization
        
        blood clotting (Koagulation, Danish)
        
        that requires
        
        four proteins within fibrin clot for synthesis
        
        is
        
        Important for infants born with a sterile gut-no bacterial synthesis
        
        Infants receive dose shortly after birth to prevent hemorrhaging
        
        deficiency
        
        in
        
        adults
        
        is rare
        
        affects
        
        People with fat malabsorption conditions
        
        due to
        
        antibiotic use
        
        Excessive intakes of vitamin E impairs role of vitamin K in blood clotting
        
        infants
        
        causes
        
        No synthesis at birth sterile gut
        
        caused by
        
        Low levels in breast milk
        
        toxicity
        
        is rare and nontoxic
        
        Coagulation effects can hinder effects of anticoagulant medications
        
        has wide safety intake range
        
        symptoms include
        
        RBC hemolysis, jaundice, brain damage
      - vitamin D
        
        is not an essential nutrient
        
        given time in sun, no need in food
        
        deficiency
        
        in
        
        children
        
        causes
        
        Rickets
        
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        adults
        
        causes
        
        osteomalacia
        (soft bones)
        
        3 more items...
        
        toxicity
        
        caused by
        
        supplement use
        
        leads to
        
        Hypercalcemia
        
        High blood calcium levels
        
        Calcium deposits into soft tissue - eg: kidneys, heart, arteries
        
        causing
        
        1 more item...
        
        none from solar synthesis through skin
        
        affects
        
        infants given inappropriate amounts the most
        
        found in
        
        food sources
        
        such as
        
        animal foods
        
        such as
        
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        plants foods
        
        such as
        
        2 more items...
        
        endogenous source
        
        hormone synthesis and action
        
        functions
        
        regulates
        
        blood calcium
        
        by
        
        calcitrol raising blood calcium
        
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        bone mineralization
        
        enhances and suppresses
        
        activity genes that regulate cell growth
        
        synthesized in body
        
        with help of
        
        sunlight
        
        from
        
        precursor that the body makes from cholesterol
        
        affected by
        
        skin colour
        
        age
        
        SPF greater than 8
        
        pollution
        
        latitude of location
        
        May to September in Vancouver
        
        time of day
        
        absorption ~50%
        
        supplements
        
        types
        
        tablets, soft gels, liquids
        
        as vitamin D2 and vitamin D3
        
        one dose a day
        
        absorption
        
        comparable to food intake
        
        fat soluble vitamin - chylomicron