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BONE HEALTH, CHARACTERISTICS, in children, Bone Health Concept Map FNH…

- - - - associated due to
        
        Genetics/Race
        
        can influence
        
        bone growth
        
        rate of bone loss
        
        density of bones
        
        Physical Activity
        
        which is shown to promote bone health due to
        
        hormones that are associated with growing muscle are also involved in bone growth
        
        Body weight
        
        Being underweight means a higher chance of getting osteoporosis
        
        Smoking or alcohol
        
        Smokers tend to have a lower body weight increasing their risk for the disease
        
        Female smokers may go through menopause early which increases rate of bone loss
        
        Alcoholics have slower bone formation
        
        alcohol is toxic to the bones
        
        Age, Gender, and Hormones
        
        AGE
        
        Different bones reach a different peak bone mass mostly achieved in one’s teenage years
        
        As we age the bone-building rate decreases
        
        extreme dieting and exercise during and beyond adolescence can compromise bone health
        
        GENDER and HORMONES
        
        Men have a lower incidence of osteoporosis due to greater bone density – and they have a gradual decline of testosterone
  - - - For young women
        
        moderate active lifestyle - especially weight bearing activities
        
        exposure to sun → Vitamin D which allows calcium binding protein in intestinal cells
        
        adequate calcium intake during growth and other nutrients
      - For adults
        
        Adequate intake of nutrients
        
        Moderate active lifestyle - especially weight bearing activities
        
        Quit smoking
        
        Drink alcohol in moderation or none at all
      - For women during menopause
        
        adequate intake of nutrients ( Ca, P, Mg, F, Vitamins D and K) that support bone health
        
        appropriate therapy, if chosen
        
        make healthy lifestyle choices
        
        remain physically active, some sun exposure
  - - - Osteoid doesn't mineralize properly and accumulates, making the bone soft and rigid
- - - - standard measure
      - Uses very low x-ray energy for entire body scan
      - Pros: non-invasive, painless, quick
      - Results can be camped with healthy 30 yrs old with the same gender and race
    - - Mostly used on heel
      - Pros: non-invasive, painless, quick
      - Uses sound wave to measure bone density
      - Cons: true value is only as a screening tool, not diagnostic
    - - X-ray used to measure bone density in heels, wrist, or finger
      - Pros: non-invasive, painless, quick
      - Cons: can only be used as a screening tool, not diagnostic
- - - - responsible for tensile strength and stability of the bone
  - - - Phosphorus and calcium
        
        lead to hydroxypatite
  - - - Ivory-like and dense
      - Mostly small and long bones
      - 80% of the entire skeleton
    - - lace-like in texture & dynamic
      - Found on ends of long bones, spinal vertebrates, pelvis & ribs
      - Sensitive to hormones that regulate levels in blood calcium
      - 20% of the entire skeleton
- - - - ROLES
        
        Nerve transmission and muscle contraction
        
        The flow of ions allow for releases of transmitters
        
        Calcium flows into muscle cell causing contraction
        
        Calcium exits muscle cell, relaxation occurs
        
        Sodium-Potassium ATPase pump in nerve cell membrane generate an action potential
        
        Essential for bone formation & maintenance
        
        Form Hydroxyapatite crustal & deposit onto PRO collagen matrix of bone
        
        Provide strength and rigidity
        
        Blood clotting
        
        Calcium is essential in blood clotting process leading to the formation of fibrin and a clot
      - TOXICITY
        
        Causes
        
        Hyperparathyroidism
        excess production of parathyroid hormone causes kidneys to retain calcium in blood and bone and released in blood
        
        Effects
        
        Hypercalcemia
        High blood and urinary calcium levels and deposits in soft tissues causing irreversible organ damage
        
        Health Effects
        
        Impair kidney function
        
        Increase pH of blood
        
        Upset stomach
        
        Nausea
        
        Vomitting
        
        Affects
        
        People with kidney disease
      - DEFICIENCY
        
        Most at risk: Women during menopause
        
        why: rate of bone loss increases along with rapid decrease of estrogen
        risks: developing osteoporosis
      - SOURCES
        
        Milk and dairy products (yogurt, cheese etc.)
        
        Legumes (tofu with calcium based salt, beans, lentils etc.)
        
        Fortified soy or plant milks
        
        Bones in canned fish
        
        Supplement
        
        Forms
        Tablets, chewable, liquid, effervescent
        
        Forms
        Carbonate, citrate, lactate, phosphate
        
        Take during times of low Calcium and/or Iron intake
        
        Take daily if Calcium intake from diet is not adequate
        
        UL: 2500mg/day and 500mg/dose
      - relationship between calcium & vitamin D:
        Vitamin D helps to make the calcium-binding protein needed for absorption, blood calcium is regulated by vitamin D and 2 other hormones
      - relationship between calcium & phosphorus: 85% of our body's phosphorus as phosphate is combined with calcium in the hydroxyapatite crystals of bones and teeth
      - relationship between calcium, phosphorus & magnesium:
        -calcium & magnesium are together involved in muscle contraction and blood clotting: calcium promotes the processes, and magnesium inhibits them. This interaction regulates blood pressure and lung function
        -Magnesium is a catalyst in a reaction that adds the last phosphate to ATP
      - relationship between calcium & vitamin K:
        Vitamin K participates in the metabolism of bone proteins, most noticeably osteocalcin. When vitamin K is inadequate osteocalcin is undercarboxylated and less effective in binding calcium to form bone
    - - ROLES
        
        Bone and Teeth
        
        Magnesium needed for Calcium regulating hormones, Vitamin D and Parathyroid hormone
        
        Needed for mineral crystal structure in bone
        
        Holds magnesium in the body
        
        Blood and Tissue
        
        Stabilizes ATP
        
        Co-factor for enzyme systems
        
        Nerve transmission and muscle contractions
        
        Prevents blood clotting
        
        Decreases the risks of hypertension and heart disease by acting as a vasodilator
      - DEFICIENCY
        
        Causes
        
        Excessive perspiration over long periods of time
        
        Prolonged vommiting/diarrhea
        
        Prolonged use of diuretics
        
        Alcoholism
        
        Kidney disease
        
        Symptoms
        
        Irregular heartbeat, loss of appetite, weakness, disorientation, hypertension
        
        Tetanus
        
        Susceptibility
        
        Risk for Mg deficiency is low b/c large stores of Mg in bones
      - TOXICITY
        
        There are no known risks of magnesium toxicity
      - SOURCES
        
        plant foods
        
        halibut
        
        hard water
    - - DEFICIENCY
        
        Unlikely due to sufficient amounts in our diet
      - ROLES
        
        Fluid Balance
        
        Major intracellular anionic electrolyte
        
        Helps to maintain proper electrical and fluid balance
        
        Blood and Tissue Phosphorus
        
        Phosphorus salt found free in cells & bloodstream and acts as a BUFFER
      - TOXICITY
        
        Low calcium intake with high phosphorus intake causes adverse effects.
      - SOURCES
        
        Supplements
        
        Adequate found in diet, therefore not necessary
        
        Animal foods
        
        Poultry
        
        Meat
        
        Fish
        
        Dairy and milk products
        
        Plant foods
        
        Nuts
        
        Legumes
        
        Cereal
        
        Bran
        
        Soft Drinks
      - relationship between calcium, phosphorus & fluoride:
        Calcium and phosphorus form crystals-hydroxyapatite, fluoride replaces the OH group of the crystal and forms fluorapatite, which makes bones stronger and teeth more resistant to decay
    - - ROLES
        
        Bone health and teeth mineralization
        
        Best taken during bone and teeth development
        
        Creates Fluorapatite with calcium and phosphate: a stronger crystal in bones and teeth
        
        Resist is decay from acid erosion
      - DEFICIENCY
        
        Those at risk:
        
        Those in areas where there is low fluoride levels in water because water is only of the main food sources of fluoride
      - TOXICITY
        
        Symptoms
        
        Condition caused by toxicity
        
        Fluorosis (white specks, mottling, or brown streaks on teeth)
      - SOURCES
        
        brewed tea
        
        water
        
        seafood
        
        seaweed, shellfish, fish
  - - - ROLES
        
        Calcium mineralization
        needed by osteoblasts to make osteocalcin needed for bone formation
        
        Blood clotting
        necessary for proteins and production of fibrin a blood coagulating protein
      - TOXICITY
        
        Symptoms
        
        Hinders anti-coagulant drugs
        
        RBC hemolysis, jaundice, brain damage
        
        Causes
        
        Risk for toxicity is low - is not from food intake but usually supplements
      - SOURCES
        
        Food Sources
        
        Green Leafy Vegetables
        
        Liver
        
        eggs, milk
        
        Peas, broccoli, green beans
        
        in cooking
        
        it is resistant in losses
        
        Non-food sources:
        
        bacteria synthesis
      - DEFICIENCY
        
        Populations at risk
        
        Due to low levels at birth, low levels in breast milk, low levels of bacteria needed to synthesize Vitamin K
    - - DEFICIENCY
        
        Can Cause both
      - SOURCES
        
        Fortified foods
        
        Orange juice
        
        Margarine
        
        Yogurt
        
        Milk
        
        Supplement
        
        Forms
        Tablets., softgels, liquid
        
        Types
        
        Plant Based
        Vitamin D2: Ergocalciferol
        
        Animal Based
        Vitamin D3: Cholecalciferol
        
        Fat soluble: Chylomicron
        
        Caution taking long term as high dowses cause soft tissue damage
        
        Recommended for adults >50 to take 10 micrograms/day
        
        UL: 250 micrograms/day in all adults
        
        Animal foods
        
        Fish and fish oils
        
        Egg yolks
        
        Liver
      - TOXICITY
        
        Causes
        
        Supplement use
        
        Sun exposure
        
        Food intake
        
        Effects
        
        Affects
        
        Children
        Vitamin D poisoning with unnecessary supplements in infants
      - ROLES
        
        Immune function
        
        Calcitriol is associated with maturation of immune cells
        
        Regulation of Blood Calcium & Bone Mineralization
        
        Acts at 3 sites: intestine, bone, kidneys to increase absorption/retention of calcium in the body
      - relationship between vitamin D and phosphorus:
        Vitamin D assists in the absorption of phosphorus, thus helping to maintain its blood concentration
- - - - Bone density is affected
  - - - Size and length of bones increase
- - - - secreted by throyid gland
      - decreases the action of osteoclasts, thus reducing the amount of calcium leaving the bone and entering the blood
      - Inhibits vitamin D activation
    - - Secreted by the parathyroid gland when the calcium is needed in the blood
      - Secreted in response to falling blood calcium.
      - Stimulates final step of vitamin D activation.
      - Parathyroid hormones levels fall resulting in an incases in urinary calcium, which calcitriol level drop leading to less calcium opsorption
    - - Active form of Vitamin D
      - Important for vitamin D synthesis and activation
      - Act on 3 sites
        
        Acts on 3 sites
        
        Intestines
        
        Increases calcium absorption.
        
        Kidneys
        
        Decreases calcium excretion in urine.
        
        Bone
        
        Increases osteoclast activity to break down bone and release calcium into blood.