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Bone Health, Dietary sources - Coggle Diagram

- - - - Size
      - Length
    - - Shaping of bone
      - Role in determining bone structure during growth
      - Influenced by mechanical stress nad fractures
    - - Balance betwwen resorption and formation
      - Regulation by hormones and mechanical stress
      - Continuous process of bone renewal
    - - Osteoblasts
        
        Bone-resorbing cells
        
        Scerete acids and enzyme to dissolve bones
        
        Regulation by hormones
        
        Large, multinucleated cells
      - Osteoclasts
        
        Scerete bone matrix
        
        Regulation by hormones
        
        Role in mineralization
        
        Bone-forming cells
  - - - Ivory-like, very dense, slow turnover,~80% skeleton
      - Outer surface
      - Small bone
    - - Lace-like, dynamtic and sensitive to hormones, ~20% of skeleton
      - Spinal vertebrae
      - Ends of long bones
      - Inside flat bone
      - Pelvis bone
- - - - Not too much, and not too little to maintain proper vitamin/mineral levels
    - - Exercising, going to the gym, keeping healthy
        
        Affects risk of acquiring certain bone related diseases
        
        builds muscle & bone strength
        
        hormones involved with bone and muscle growth benefit from physical exercise
        
        sitting on a couch or being confined to bed causes bone loss
    - - Use during inadequate intake from diet, pregnancy, or when internal levels are low
        
        Sometimes prescribed by doctors
    - - Affects absorption of calcium
        
        Leads to lower bone density and weaker bones
      - Nicotine slows production of bone-forming cells
      - Alcohol interferes with bone growth and replacement of bone tissue
        
        decreased bone density and increased risk of fractures
  - - - DEXA - Dual Energy X-ray Absorptiomerty
        
        Non-invasive
        
        Painless
        
        Relatively quick
        
        Very low x-ray energy scan
        
        T-score
        
        Compared with healthy 30-year old of same gender and race
        
        Normal
        
        +1 to - 1
        
        Osteopenia
        
        -1 to -2.5
        
        Low bone mass
        
        Increased risk of fracture
        
        Osteoporosis
        
        Lower than -2.5
        
        High risk of fracture
      - Ultrasound
        
        Sound waves
        
        measures bone density
        
        Often use the heel
        
        Non-invasive
        
        Painless
        
        No diagnostic use
      - pDEXA - Peripheral Dual Energy X-ray Absorptiometry
        
        X-ray
        
        Measures bone density
        
        Heel
        
        Wrist
        
        Finger
        
        Non-invasive
        
        Painless
        
        No diagnostic use
- - - - Primary role: regulate blood Ca and bone metabolism
        
        Calcitonin acts at 3 sites
        
        Intestines
        
        Kidney
        
        Bones
      - other role: helps with immune function - maturity of immune cells
      - Deficiency
        
        Children
        
        Rickets disease: poor mineralization & bone shaping, bowed legs, malformed ribs
        
        Adults
        
        Osteomalacia disease, osteoid cant mineralize properly & accumulates = soft bones
      - Most likely toxicity cause:
        
        Solar exposure, foot intake, supplement use
        
        Consequences: Hypercalcemia
    - - Key roles
        
        Calcium mineralization in bone matrix - produce osteocalcin
        
        Required for proteins produce fibrin - blood clotting
      - Deficiency risk
        
        Infants
        
        Low levels at birth
        
        Low levels in breast milk
        
        Low level gut bacteria to synthesize vitamin K
        
        Adults
        
        People with fat malabsorption disorders, especially if on antibiotics
  - - - Primary role: Bone formation & maintenance
      - Non-bone important roles
        
        nerve transmission/muscle contraction
        
        Essential to form fibrin, allow blood clotting
        
        Preventative effect on hypertension at ~1000mg per day
      - Factors increasing absorption
        
        estrogen enhances vitamin D activation, increasing Ca absorption
        
        Lactose intake increases absorption
        
        younger people absorb Ca better
      - Factors decreasing absorption
        
        Food constitutes
        
        High fibre, high fat intake
        
        Foods rich in phytic acid & oxalic acid - whole grains, legumes, veggies
        
        Polyphenols - tea, coffee
        
        Supplement use - Magnesium & Phosphorus, Iron & Zinc
        
        Menopause, lower estrogen
      - Deficiency: Osteoporosis
        
        Risk factors
        
        Gender, age, hormones
        
        Genetics, race
        
        Physical activity and body weight
        
        Smoking and alcohol
    - - Primary role: Maintain bone strength and rigidity with Ca
      - Non-bone important roles
        
        Maintain proper electric and fluid balance
        
        Blood & tissue phosphorus
      - Factors increasing absorption
        
        Vitamin D
      - Factors decreasing absorption
      - Greatest risk for deficiency
    - - Key roles
        
        Maintains healthy bone & teeth
        
        Blood & tissue magnesium
        
        Protects against hypertension & heart disease
  - - - Major role: Bone & teeth mineralization
        
        Most effective before teeth erupt through gums
        
        Best taken during bone + teeth development
      - Toxicity causes condition: Fluorosis
        
        signs: white specks, mottling, brown streaks on teeth
      - Risk for deficiency:
- - - - Caused by: Hyperparathyroidism
        
        Kidneys retain calcium in blood and bone due to excess production and secretion of parathyroid hormone
        
        Causes organ damage, calcium deposits in soft tissues, and high blood & urine calcium levels
        
        Most affects those with kidney disease
  - - - 9-18yrs old: RDA 1300, UL 2500
      - 19-50yrs old: RDA 1000, UL 2500
      - 51+ yrs old: RDA 1200, UL 2000
    - - 9-18 yrs old: RDA 1300, UL 2500
      - 51-70 yrs old: RDA 1200, UL 2000
      - 71+ yrs old: RDA 1200, UL 2000
  - - - Decreased bone density, increased bone fragility,
        
        1 out of 4 women, and 1 out of 8 men over 50 are diagnosed with it
        
        Affected by age, gender, and hormones, physical activity, smoking/alcohol and weigh
        
        low calcium, vitamin D, and fluoride intake increase risks
        
        Those who don't consume dairy products should intake calcium and vitamin D supplements
  - - - Avoid:
        
        Unrefined oyster shell, coral, bone meal
        
        Can be high in heavy metals unless refined
      - Common forms: carbonate, citrate, lactate, phosphate
  - - - Vitamin D
      - Calcitonin
      - PTH
- - - - Jaundice
      - Brain damage
      - RBC hemolysis
  - - - Broccoli
      - Spinach
      - Asparagus
      - Kale
      - Collards
  - - - DRI-AL ug/day: 120
        
        DRI-UL: NONE
    - - DRI - AL ug/day: 90
  - - - can be due to antibiotic use
      - Seen in people with Fat malabsorption condition
      - Excessive Vitamin E intake will impair Vitamin K roles in blood clotting
    - - low levels in breast milk, low levels in gut bacteria after a few weeks, sterile gut at birth
        
        sterile gut means no Vitamin K synthesis can occur
- - - - DRI-RDA ug/day
        
        71yrs +: 20 (800UI)
        
        9-70yrs: 15 (600UI)
    - - 100 (4000 IU)
  - - - Improper mineralization, bones become deformed
        
        Happens when breast milk is low in Vitamin D, or low intake in general
        
        Increasing prevalence in Canada
        
        Legs are over bend outwards, caused by gravity
    - - Improper osteoid mineralization within bones causes mineral build up
        
        bones will grow soft and flexible, not rigid
        
        Causes by:
        
        kidney, liver, and intestinal diseases
        
        Low Vitamin B intake or low sun exposures
        
        Closely spaced, repeated pregnancies
        
        Treatment:
        
        Vitamin D supplements
        
        Increased Vitamin D intake
        
        Increased sun exposure (regulated)
      - Soft bones