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Bone Health - Coggle Diagram

- - - - Primary roles are...
        
        Blood calcium regulation
        
        Calcitriol raises blood calcium via...
        
        3 sites
        
        Kidney
        
        Decreases
        
        1 more item...
        
        Bones
        
        Increases
        
        1 more item...
        
        Intestine
        
        Increases
        
        1 more item...
        
        Supporting bone mineralization
      - Secondary role involves...
        
        Immune function
        
        Calcitriol...
        
        Supports maturation of...
        
        Immune cells
    - - Children
        
        Rickets
        
        Improper mineralization and shaping of bones
        
        Knock-knees
        
        Bowed legs
      - Adults
        
        Osteomalacia
        
        Osteoid does not mineralize properly
        
        Lower back and leg pain
        
        Soft and flexible bones
    - - Effect
        
        Increases calcium absorption
        
        Hypercalcemia
        
        High blood calcium
      - Cause
        
        Supplement use
        
        Relatively narrow safety intake range
      - Increased risk
        
        Infants
        
        Given inappropriate doses
      - Non-toxic sources
        
        Food and sunlight
    - - Exogenous intake
        
        Fortified foods include...
        
        Fortified milk
        
        Margarine
        
        Orange juice
        
        Yogurt
        
        Primary sources include...
        
        Animal-based foods
        
        Egg yolks
        
        Liver
        
        Fish and fish oils
      - Endogenous synthesis
        
        Factors affecting synthesis
        
        Skin colour
        
        Age
        
        Sun protection factor
        
        Pollution
        
        Latitude
        
        Sunlight exposure time
        
        Requires sunlight exposure
    - - Step 1
        
        Vitamin D2/D3
        
        Hydroxylated in liver
        
        Becomes calcidiol
      - Step 2
        
        Calcidiol
        
        Hydroxylated in kidney
        
        Becomes calcitriol
    - - Advisable for...
        
        Individuals with limited...
        
        Sunlight or dietary intake
        
        Older adults with...
        
        Decreased absorption efficiency
      - Can support
        
        Calcium absorption
        
        Bone health
    - - Functions as a prohormone
        
        Requires two-step activation
      - Synthesized in skin
        
        Requires sunlight exposure
  - - - Bone health
        
        Calcium mineralization
        
        Essential for osteoblasts
        
        To create...
        
        Osteocalcin
      - Blood clotting
        
        Crucial for infants
        
        Born with sterile gut
        
        Lack bacteria to synthesize vitamin K
        
        Dose of vitamin K
        
        Prevents hemorrhaging
        
        Fibrin clot
        
        Has 4 proteins that...
        
        Require vitamin K for synthesis
    - - Likelihood
        
        Rare for adults
        
        Fat malabsorption conditions
        
        Cystic fibrosis
        
        Acquired immunodeficiency syndrome
        
        Crohn's disease
        
        Excessive intake of vitamin E...
        
        Impairs role of vitamin K in....
        
        Blood clotting
        
        Usually due to antibiotic use
        
        Kills gut bacteria that...
        
        Produces vitamin K
        
        High for infants
        
        Born with sterile gut
        
        Lack bacteria to synthesize vitamin K
        
        At risk for...
        
        Hemorrhagic disease
        
        Low levels in...
        
        Breast milk
        
        Gut bacteria
        
        After a few weeks
    - - Food sources
        
        Plant-based foods
        
        Cauliflower
        
        Cabbage
        
        Avocado
        
        Leafy greens
        
        Broccoli
        
        Kale
        
        Swiss chard
        
        Spinach
        
        Brussel sprouts
        
        Asparagus
        
        Collards
        
        Animal-based foods
        
        Cow milk
        
        Eggs
        
        Liver
        
        During cooking...
        
        Resistant to losses
      - Non-food source
        
        Large intestine
        
        Bacterial synthesis of vitamin K
    - - Rare
        
        Wide safety intake range
        
        Non-toxic
      - Coagulation effects...
        
        Interferes with...
        
        Anti-coagulants
      - Symptoms
        
        Jaundice
        
        Brain damage
        
        Red blood cell hemolysis
    - - Osteocalcin which...
        
        Binds calcium to the bone matrix
        
        Supporting bone mineralization
- - - - Toxicity
        
        No known adverse effects from food
      - Deficiency
        
        Symptoms include....
        
        Disorientation
        
        Weakness
        
        Irregular heartbeat
        
        Tetany in severe cases
        
        Hypertension
        
        Irritability
        
        Develops slowly due to bone reserves
        
        Risk factors include...
        
        Heavy perspiration
        
        Prolonged vomiting or diarrhea
        
        Kidney disease
        
        Prolonged diuretics usage
        
        Alcoholism
        
        Severe symptoms
        
        Rare for healthy individuals
      - Roles
        
        Blood and tissue
        
        Required for...
        
        More than 300 enzymes
        
        Fat
        
        Protein
        
        Nucleic acid synthesis
        
        Stabilizes phosphate groups in...
        
        Adenosine Triphosphate
        
        Nerve transmission and contraction
        
        Supports neurotransmitter activity
        
        Inhibits muscle contraction
        
        Inhibits blood clotting
        
        Bone and teeth
        
        Indirectly affects calcium balance
        
        Required for...
        
        Parathyroid hormone and vitamin D action
        
        Used in mineral crystal structure of bone
        
        Can replace calcium in...
        
        Hydroxyapatite
        
        Reservoir in bone
        
        Retains calcium in teeth
        
        Reducing dental caries
        
        Protects against...
        
        Hypertension (high blood pressure)
        
        Lowers rates of heart disease
        
        In regions with...
        
        Hard water
        
        Acts as a...
        
        Vasodilator
      - Food sources include...
        
        Best sources
        
        Plant-based foods
        
        Legumes
        
        Whole grains
        
        Green leafy vegetables
        
        Located in centre of chlorophyll
        
        Animal-based foods
        
        Milk
        
        Yogurt
        
        Halibut
        
        Hard water
      - Can replace calcium in hydroxyapatite
    - - Secondary roles involve...
        
        Supporting nerve transmission and muscle contraction
        
        Supporting blood clotting
        
        Reducing hypertension (high blood pressure)
      - Food sources include...
        
        Milk and dairy products
        
        Canned fish with bones
        
        Fortified plant-based milks
        
        Soup stock made from fish or meat bones
      - Deficiency
        
        Consequence
        
        Osteoporosis
        
        Symptoms
        
        Increased risk of fracture
        
        Increased bone fragility
        
        Decreased bone density
        
        Likelihood
        
        in Canada if over the age of 50
        
        1 of every 8 men
        
        1 of every 4 women
        
        Risk factors
        
        Low body weight for women
        
        Genetic predisposition
        
        Smoking and alcohol
        
        Low levels of fluoride, vitamin D, and calcium during childhood
        
        Excess sodium, coffee, and protein
        
        Old age
        
        Decreased sex hormones
        
        Low physical activity
        
        Strategies to reduce bone fracture risk
        
        Adequate nutrient intakes of...
        
        Calcium, phosphorus, magnesium, fluoride,
        and vitamins D and K
        
        Moderately active lifestyle
        
        Medical therapy
        
        Quit smoking
        
        Limit alcohol intake
        
        Who is at greatest risk?
        
        Physically inactive individuals
        
        Postmenopausal women
        
        Individuals genetically predisposed to low bone mass
        
        Underweight women
        
        Individuals with poor calcium, fluoride, and vitamin D intake
        
        During childhood
        
        Individuals who smoke or consume alcohol
      - Toxicity
        
        Cause
        
        Hyperparathyroidism
        
        Excess production and release of...
        
        Parathyroid hormone
        
        Bone releases calcium in blood
        
        Kidneys conserve calcium in blood
        
        Effect
        
        Hypercalcemia
        
        High blood and urinary calcium levels
        
        Calcium deposits into soft tissue
        
        Irreversible organ damage
        
        People most affected
        
        Individuals with kidney disease
      - Absorption
        
        Decreased absorption due to...
        
        Food constituents
        
        High fibre and fat
        
        Oxalic and phytic acid
        
        Polyphenols
        
        Old age
        
        Decreased gastric acid
        
        Menopause
        
        Decreased estrogen
        
        Vitamin D deficiency
        
        Increased absorption due to...
        
        Slight acidic pH in duodenum
        
        Promotes calcium ionization and solubility
        
        Lactose
        
        Binds calcium to form an...
        
        Absorbable complex
        
        Young age
        
        Stronger calcium-absorbing mechanisms
        
        Increased Vitamin D, gastric acid, hormonal support
        
        Increased need for calcium during periods of growth
        
        Body increases absorption efficiency
        
        Transcellular pathways activated by...
      - Primary role is...
        
        Bone formation and maintenance
        
        Key component in...
        
        Hydroxyapatite
        
        Provides bone strength and rigidity
      - Storage
        
        99% found in bones and teeth
        
        Osteoblasts
        
        Build bone
        
        Store calcium in bone
        
        Supports blood calcium regulation
        
        Osteoclasts
        
        Break down bone
        
        Release calcium from bone
      - Supplement use
        
        Advisable if at risk for deficiency
        
        Mineral-mineral interactions
        
        Decreased absorption of iron and magnesium
        
        Take divided doses (max 500mg)
    - - Primary role is...
        
        Supporting bone health
        
        Key component in...
        
        Hydroxyapatite
        
        Provides bone strength and rigidity
      - Secondary roles involve...
        
        Blood and tissue phosphorus
        
        Buffer in blood
        
        Key component in phospholipid bilayer
        
        Fluid balance
        
        Major intracellular anionic electrolyte
      - Toxicity
        
        High phosphorus intake with low calcium intake
        
        During teenage years
        
        Lowers peak bone density
        
        Rare with food intake
      - Food sources include...
        
        Soft drinks
        
        Milk
        
        Legumes
        
        Animal protein foods
      - Deficiency
        
        Unlikely
        
        Widely available when consuming varied and well-balance diet
      - Absorption
        
        Decreased absorption due to...
        
        High intake of...
        
        Increased absorption due to...
      - Supplement use
        
        Unnecessary with a healthy diet
      - Essential components of major mineral crystal in bone (Hydroxyapatite)
        
        Major minerals found in bone
  - - - Sources include...
        
        Animal-based foods
        
        Fish
        
        Sardines
        
        Seafood
        
        Shellfish
        
        Non-food sources
        
        Fluoridated water
        
        Mouthwash
        
        Toothpaste
        
        Plant-based foods
        
        Brewed tea
      - Toxicity
        
        Fluorosis
        
        In skeleton...
        
        Stiffness and pain in joints
        
        Brittle bones
        
        Risk of osteoporosis
        
        Abnormal hardening
        
        In teeth...
        
        Permanently discoloured
        
        More resistant to decay
        
        Brown specks or white streaks
        
        Commonly seen in children
        
        Excessive ingestion of toothpaste or fluoride drops
      - Deficiency
        
        Risk factors include...
        
        Low supply in water
        
        Increased risk for dental caries
        
        Limits consumption of...
        
        Variety of foods
        
        Inability to chew
        
        Dental hygiene quality
        
        Non-fluoridated toothpaste
      - Primary role is...
        
        Mineralization of...
        
        Bone and teeth
        
        Can replace the hydroxyl group in...
        
        Hydroxyapatite
        
        Creating a stronger crystal
        
        1 more item...
      - Effectiveness
        
        Increases when taken...
        
        Before teeth erupt
        
        Permanent teeth formation
        
        3-4 years of age
        
        Baby teeth formation
        
        20th week of pregnancy
        
        Wisdom teeth formation
        
        8-10 years of age
        
        Decreases with age
        
        In adults...
        
        Topical treatment is...
        
        Protective
        
        Antimicrobial
        
        1 more item...
        
        Re-mineralizes enamel lesions
      - Can replace hydroxyl group in hydroxyapatite
        
        Providing structural support alongside calcium and phosphorus
- - - - Provides strength
  - - - Provides flexibility
- - - - Attach to bones
    - - Protects organs
    - - Enable chewing
  - - - Manufactured in bone marrow
- - - - Activates vitamin D
      - Increases calcium reabsorption in kidneys
      - Activates osteoclasts
    - - Enhances calcium absorption in intestines
  - - - Limits calcium absorption in intestines
      - Inhibits activation of...
        
        Vitamin D
        
        Osteoclasts
      - Prevents calcium reabsorption in kidneys
- - - - Bone mineral density