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Acid base, calcium, protein and vitamin D: Key nutrients for bone health -…
Acid base, calcium, protein and vitamin D: Key nutrients for bone health
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calcium and bone health
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UK clinical guideline for the prevention and treatment of osteoporosis= calcium (diet focus, inclusion of supplements only if needed), vitamin D supplementation, protein (need to avoid low intake) [Royal College of Physicians Guidelines, 2000)
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vitamin D and health
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Early work on vitamin D: Found Cod liver oil and sunlight prevented Ricketts (Dr Chick, 1922)
Vitamin D converting enzymes involved in VITAMIN D PATHWAY: Vitamin D precursor absorbed by UVB and converted to pre-vitamin D3 (NEEDS TO BE DIRECT EFFECT OF SUNLIGHT and not hidden by clothing or windows)
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Cannot get toxic levels of vitamin D by sun exposure as excess converted to inactive form (threshold for metabolic pathway is 25/30 mins sunlight)
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Vitamin D is needed to prevent rickets, adult osteomalacia (Adult ricketts), osteoporosis (weather effect vitamin D, only absorb in UK April till September). When shadow is longer than height, you make no vitamin D (Holloway, 1990 in Lancet)
Symptoms of mild osteomalacia - tiredness, bone ache (require SACN reccomended 10ug/day vitamin D)
Vitamin D3 foods: salmon , egg yolks, cereal, fortified milk or Vitamin D2: mushrooms and leave in sunlight and UV radiated mushrooms
VITAMIN D AND ETHNICITYD-FNIES STUDY, 2012: extensive vitamin D issues in white Caucasian and South Asian populations (Informed DoH and PHE reccomendations for 10 ug/day)
25(OH)D nmol/L lower in Asian women throughout the year than cuacasian women and asian women extremely deficient throughout the year. Therefore, need higher levels.
UK Biobank study of serum 25(OG)D - Vitamin D defcieincy is almost universal in UK south asian women with 92% <50nmol/L and 55% <25nmol/l and 20% <15 . 10% below detection limit. Supplement use also low
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Vitamin D cycling: high levels seen in summer and much lower in winter- is this beneficial? About 30% vitamin D deficient in summer so recommendations of 10ug/day for WHOLE YEAR but best to stop from April to september if outside
Some studies show detrimental associations of high vitamin D levels- could be due to slow adaption of vitamin D hydroxylase enzymes to fluctuating levels so high levels may be detrimental.
Study showed those who cycled seasonally the most, had increased bone resorption= want to keep levels steady).
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FOOD SOURCE OF VITAMIN D: Vitamin D2 (plant source) vs D3 from food (animals source)- vitamin D3 50% better at raising vitamin D levels in white caucasian and south asian women- infomred DoH and PHE and food industry.
when lose weight, vitamin D rises as vitamin D stored in fat cells. People who are overweight or obese will have lower levels as weight loss releases more vitamin D
Vitamin D and immune homeostasis vitamind D receptors and enzymes found in immune cells. Meta-analysis of RCT show supplement of Vit D show lower mortality in elderly deficient.
Vit D and respiratory tract infections: SACN recommend supplementation for prevention of respiratory tract infections in addition to muscular-skeletal health
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