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Bone Health (ABOUT BONES (BONE FORMATION AND MAINTENANCE (bone development…

- - - - Trabecular Bone
      - Cortical Bone
    - - osteoclast cells
      - osteoblast cells
    - - Bone Remodeling
      - Bone Modleing
      - Bone Growth
  - - - Generate a “T-score” from comparison
      - Very low X-ray used for entire body
    - - Often used at health fairs
      - Sound waves used for heel
    - - Often used at health fairs
      - X-ray used for heel, wrist or finger
  - - - directly affect bone Ca level and indirectly affect blood Ca level
        
        regulated by 3 hormones
        
        parathyroid hormone
        
        calcitonin
        
        calcitrol
        
        low blood calcium level
        
        can cause Ca tetanus in muscles
        
        high blood calcium level
        
        can cause calcium rigor in muscles
        
        blood Ca homeostasis: 10 mg Ca/day
        
        blood Ca levels don't affect the bone Ca status
- - - - Primary
        
        Essential for bone formation and maintenance
        
        With Phosphate salts form Hydroxyapatite crystal that provides strength and rigidity to bones
      - Other
        
        nerve transmission and muscle contraction
        
        Blood clotting
        
        Hypertension
    - - Increase
        
        Active Vitamin D
        
        Age: younger absorb better
        
        increase demand for absorption
        
        lactose--forms absorbable complex
      - Decrease
        
        Food consume: fibre, high fat, Vitamin D deficient, polyphenols
        
        Supplement use: high Magnesium, Phosphorus Zinc and Iron
        
        Age : olde--decreased stomach acidity that decreased efficiency of absorption
        
        Menopause decrease estrogen
    - - cause
        
        osteoporosis
        
        Be prevented?
        
        Want to reduce the RAT of the bone loss
        
        Estrogen therapy
        
        Vitamin D therapy
        
        Calcitonin Therapy
        
        Bisphosphonate Therapy
        
        Bone loss is a natural process of aging
        
        Factors affecting risk
        
        genetics/ race
        
        Physical activity
        
        Body weight
        
        Smoking and alcohol
        
        Calcium nutrition and associated nutrients
        
        age/ gender/ hormones
        
        Factors with reducing the potential for fractures
        
        Yong Women
        
        ensure right intake of Calcium, phosphorus, Magnesium , fluoride and Vitamins D&k
        
        Regular menstrual cycles and ovulation
        
        Adult Women & men
        
        adequate intake of nutrients that support bone health
        
        moderately active lifestyle, especially weight-bearing activities
        
        quit smoking; moderate, if any, alcohol intake
        
        Menopausal Women
        
        adequate intake of nutrients that support bone health with
        appropriate therapy (if any) determined in consultation with health care professional
        
        remain physically active; make healthy lifestyle choices
    - - cause
        
        Hyperparathyroidism
      - Effects
        
        Hyperparathyroidism (high blood and urinary calcium levels, can cause irreversible damage to organs)
      - People most affected
        
        People with kidney disease
    - - Advisable to people who absorbed inversely proportional to intake or old age, choose calcium supplements ≦500 mg/dose
      - Why? Because at old age, decreased stomach acidity, that decreased efficiency of absorption
    - - most milk and milk products and fortified soy and other plant-based beverages
    - - RDA
        
        9-18: 1300 mg/day
        
        19-50: 1000 mg/day
        
        51-70: Males: 1000 mg/day; Female:1200 mg/day
        
        71+: 1200 mg/day
      - UL
        
        Males & females under 50: 2500
        
        Males & females above 50: 2000
  - - - Enhances Phosphorus absorption
      - Less dietary concern than calcium
    - - Essential for bone formation and maintenance
      - With calcium salts form Hydroxyapatite crystal that provides strength and rigidity to bones
      - Other roles:
        
        Fluid balance and Blood and tissue phosphorus
    - - Not true toxic
    - - Unlikely
      - May see neuromuscular, skeletal hematological and renal malfunctioning
    - - No needed, plentiful in diet
    - - Animal protein food-eat, fish, poultry
      - Milk and milk products
      - Legumes, cereal, bran and nuts
      - Soft drink
    - - RDA: 700mg/day
      - 4000 mg/day
  - - - Bone and Teeth
        
        Needed for action for calcium hormones, vitamin D and PTH
        
        Needed for mineral crystal structure in bone
        
        Mg reservoir in the body
      - Blood and Tissue Magnesium
        
        Stabilize high energy phosphate bond
        
        Co-factor in enzyme system
        
        Needed for nerve transmission and muscle contraction
        
        Bloodclotting
      - Hypertension
        
        Protects against hypertension and heart disease
    - - Increased loss due to:
        
        Heavy perspiration over long time
        
        Prolonged vomiting and/or diarrhea
        
        Prolonged use of diuretics
        
        Kidney disease
        
        Alcoholism
      - Symproms
        
        Irregular heartbeat
        
        Loss of apetite
        
        Weakness
        
        Disorientation
        
        Hypertension
        
        Tetany
    - - Pharmacologic doses may result in diarrhea and abdominal cramps
      - No known adverse effects
    - - Central location in chlorophyll
      - Plant food
        
        Whole grains
        
        Nuts
        
        Seeds
        
        Tofu
        
        Legumes
        
        Spinach
      - Halibut
      - Hard water
    - - UL
        
        Male and female: 350 mg
        
        Use of Calcium supplement may interfere with Mg absorption
      - RDA
        
        Males (19-30 yr): 400 mg/day
        
        Males (31+ yr):420 mg/day
        
        Females (19-30 yr): 310 mg/day
        
        Females (31+ yr): 320 mg/day
- - - - essential for blood clotting
      - 40-80% absorbed with dietary lipids andd incorporated into chylomicron
      - Family of compounds
        
        quinones
    - - calcium mineralization in bone matrix
        
        needed by osteoblasts to synthesize osteocalcin (needed for normal bone formation)
      - blood clotting
        
        necessary for proteins in the production of fibrin (a blood clotting protein)
        
        k for coagulation in Danish
    - - infants
        
        low levels at birth, and in breast milk
        
        low levels of bacteria in gut to synthesize vitamin K
      - Adults
        
        rare and usually due to use of antibiotics
        
        excessive vitamin E intake can impair the role of vitamin K in blood clotting
    - - rare
      - food sources are considered non toxic
      - excessive vitamin K can hinder effects of anti-coagulant drugs
      - symptoms
        
        jaundice
        
        brain damage
        
        RBC hemolysis
    - - AI
        
        Adult Females
        
        90 ug/ day
        
        Adult Males
        
        120 ug/day
        
        Typical intakes are adequate
      - UL
        
        none
    - - animal products
        
        eggs
        
        liver
        
        milk
      - resistant to nutritional loss from cooking
      - green leafy vegetables
  - - - Absorbed into chylomicrons for transport in the lymph and subsequent entry into the blood
    - - Regulates blood calcium and bone metabolism
      - Calcitriol acts at 3 sites-Can help increase calcium blood levels when it was low
        
        3 sites:
        
        Intestine: increase calcium absorption
        
        Bone: activates osteoclast cells to release calcium from bone into blood
        
        Kidneys: decrease calcium excretion
    - - Children: Rickets Disease
        
        leg bones most frequently bend out “bowed legs” when infant starts walking, effect of gravity; can also see “knock-knees”
      - Adult: Osteomalacia Disease
        
        see progressive weakness with increasing pain in lower back and legs
    - - Cause: solar exposure, food intake, supplement use
      - Effects: hypercalcemia
      - People most affected
        : children
    - - Advisable to people who not consuming milk and milk products
      - ~1 g calcium/day, in divided dose--maximum 500mg/ calcium
    - - RDA: adult(0-70) 15μg/day; 71+: 20μg/day
      - UL: all adults: 100 μg/d
    - - Primary animal food: egg yolk, liver, fish and fish oils
      - Fortified foods, or supplements
- - - - ubiquitous
        
        Soiltext
        
        Water Supplies
        
        Plant foods
        
        Animal foods
      - 30 - 80% absorbed
      - reduce risk for fomation of dental caries
        
        during teeth development before teeth erupt through the gums
    - - Bone and Teeth Mineralization
        
        Fluoride replaces hydroxyl group in hydroxyapatite crystals found in bone and teeth
        # #
        
        Fluorapatite
        
        more resistant to decay from acid erosion
        
        More effective before teeth erupt through the gums
        
        a stronger crystal in bones and teeth
      - Topical treatment as adults helps protect against dental caries
      - Antimicrobial
        
        helps fill in surface micro-lesions
    - - Increase risk of dental caries
        
        inability to chew properly
        
        inability to consume a wide variety of foods
    - - Fluorosis
        
        white specks, mottling or brown streaks on teeth
      - abnormal hardening of skeleton
        
        more brittle bones
        
        osteoporosis
        
        stiffness and pain in joints
    - - Water (not bottled)
      - Seafood
      - Brewed tea
      - Seaweed
      - Shellfish
      - Fish
    - - AL
        
        Adult Male
        
        4 mg/day
        
        Adult Female
        
        3 mg/day
      - UL
        
        All Adults
        
        10 mg/day