Module 11 Nutrition

Why is higher bone mineral density at age 25 predictive of better bone health at age 65?

--Minerals provide strength and structure to withstand fractures. --Beginning adulthood with high bone mineral density lessens the impact of inevitable age-related bone loss.

Why is trabecular bone demineralized more rapidly than cortical bone after menopause?

--Osteoblast activity decreases, but osteoclast activity remains high. --Trabecular bone has a higher density of osteoblast and osteoclast cells.

Who is likely to benefit from supplements containing vitamin D?

--People with fat malabsorption --Breastfed infants with limited sun exposure --Strict vegetarians (i.e., vegans)

Excessive intake of which of the following dietary constituents may harm bone health?

--alcohol --phosphorus --caffeine

Arrange the following foods in order from highest (at the top) to lowest (at the bottom) vitamin D content.

--baked salmon 3oz --nonfat (skim) milk, 1cup --egg, 1 each --butter, 1 teaspoon

Additional health benefits of calcium include

--blood clot formation --cellular differentiation --normal blood pressure

The consequences of osteoporosis are

--decreased physical ability. --bone fractures. --pain and deformity.

Menopause may lead to a rapid loss of bone mass because

--estrogen is required for maximal osteoblast activity.

Sources of vitamin D include

--fortified foods. --synthesis in the skin from sun exposure. --fatty fish

Calcium absorption is increased by

--high blood levels of parathyroid hormone. --the presence of lactose in the diet. --pregnancy.

Supplementation may be required to meet the RDA for vitamin D for individuals with

--inadequate sun exposure. --vegan diets. --milk allergies.

Factors that increase the risk of developing rickets include

--inadequate vitamin D intake. --cystic fibrosis.

Absorption of calcium is increased during

--infancy. --pregnancy.

The periosteum

--is connected to muscles, tendons, and ligaments. --Is found on the outer surface of bones.

Risk factors associated with osteomalacia include

--kidney disease. --poor intestinal absorption.

Bone resorption results in

--loss of bone mineral density. --release of calcium, phosphorus, and magnesium into the blood.

With the goal of preventing osteoporosis, a young woman should

--meet dietary needs for calcium. --meet dietary needs for protein. --perform weight-bearing physical activity.

Populations that may be at risk for marginal phosphorus status include

--older adults with nutrient-poor diets. --preterm infants. --alcoholics.

Estrogen therapy is used to

--prevent bone resorption. --relieve menopausal symptoms.

Among typical Americans, deficiencies of phosphorus are

--rare because the mineral is widespread in the diet. --rare because the hormonal control of phosphorus is effective.

The vitamin D hormone affects bone metabolism by

--regulating intestinal absorption of calcium. --aiding in depositing calcium in the bones.

Good options for vitamin D supplementation include

--vitamin D supplements. --fruit juice fortified with vitamin D.

To balance the risk of skin cancer from too much sun exposure with the sun exposure we need to produce vitamin D, children and adults should expose hands, face, and arms to sunlight for ______ minutes daily.

10

The UL for vitamin D is micrograms daily.

100

What is the UL for vitamin D for adults?

100 micrograms

The Recommended Dietary Allowance for calcium for adults between the ages of 19 to 50 is ----mg.

1000

The Recommended Dietary Allowance for calcium for adults between the ages of 19 to 50 is mg.

1000

The RDA for vitamin D for adults is micrograms per day.

15

Where is 85% of the phosphorus in the body found?

Bone

How is body weight related to bone mass?

Higher body weight tends to increase bone mass due to extra stress on bone.

______ may worsen bone health by increasing urinary excretion of bone-building minerals, such as calcium or magnesium.

Medications

How much of the phosphorus in the diet is absorbed by the body?

Most

The thick, fibrous membrane that covers the outer surface of bones is called the ______.

Periosteum

Of the following bone-building nutrients, which is LEAST likely to be deficient in the diets of typical Americans?

Phoshorus

Milk, cheese, meat, and bread are all rich sources of

Phosphorus

The results of DEXA measurements are known as

T scores.

Excessive alcohol intake contributes to osteoporosis.

True

True or false: Although cottage cheese is made from milk, it does not provide as much calcium as other dairy products.

True

For a healthy 24-year-old female, the ______ for calcium is 2500 mg/day.

UL

Which of the following lifestyle factors may help young women prevent osteoporosis?

Using fortified foods to make up for specific nutrient shortfalls, such as vitamin D and calcium

______ fractures associated with osteoporosis may lead to problems with breathing and digestion

Vertebral

______ fractures associated with osteoporosis may lead to problems with breathing and digestion.

Vertebral

Why could a person with adequate calcium intake but a deficiency of vitamin D be at risk of bone fractures?

Vitamin D is necessary for calcium absorption.

Blood cells are derived from ______ cells in the bone marrow.

hemopoietic

Where does vitamin D act to regulate blood calcium levels?

intestine kidney bone

Calcium supplements may decrease ______ absorption.

iron zinc

Large amounts of phytic acid found in fiber from grains, excess phosphorous, polyphenols in tea, and vitamin D deficiency all contribute to ______.

limiting calcium absorption

Bisphosphonates prevent bone loss by

limiting osteoclast activity.

A person with dark skin would need a ______ exposure time to sunlight to synthesize vitamin D.

longer

Tetany may result from ______ levels in the blood.

low calcium

Which of the following types of bone tissue contains stem cells?

marrow

Highly trained athletes are at risk for bone loss if

menstruation becomes irregular or ceases altogether.

For which of the following population groups does typical calcium intake fall short of recommendations in the United States?

older adult men young adult women adolescent girls

Bone-building cells are called .

osteoblasts

Cells that synthesize new bone are

osteoblasts

Mrs. Tyson is 63 years old and takes steroids to control her arthritis pain. The results of her DEXA showed a T-score of -2.0. This T-score is indicative of

osteopenia.

Vitamin D toxicity is most likely to result from

overuse of supplemental vitamin D.

Which mineral is part of the genetic code in every cell, a functional component of bones and teeth, and a primary component of ATP?

phosphorus

Choose the minerals that have a role in building/maintaining bone strength.

phosphorus magnesium calcium

Active vitamin D enhances the absorption of calcium and

phosphorus.

Active vitamin D increases intestinal absorption of

phosphorus. calcium.

Phosphorus is generally well absorbed, but absorption of phosphorus from grain products is limited somewhat by the presence of

phytic acid.

The main function of cortical bone is to

provide strength and stability.

______ is the vitamin D deficiency disease characterized by bowed legs, an enlarged head, deformities of the ribs and pelvis, and pain in the joints.

rickets

Food sources for obtaining vitamin D include

salmon. fortified milk.

Which of the following factors may affect vitamin D synthesis by the skin?

skin pigmentation age latitude

Calcium requires an acidic environment in the GI tract to be absorbed efficiently. Absorption of calcium occurs primarily in the upper part of the

small intestine.

Common sites for osteoporotic fractures include

spine. wrist. pelvis.

Which of the following exercises is the best choice for maintaining bone mass?

strength training

In the process of bone remodeling, osteocytes

synthesize new bone.

If blood calcium falls below a critical point, muscles cannot relax after contraction; the body stiffens and shows involuntary twitching, called ______.

tetany

Exercise is beneficial for bone health because

the additional stress on bone increases bone mineral density.

Overweight and obese adults are likely to have higher bone mineral density than adults of healthy weight because

the stress of extra weight on the bones increases bone mineral density.

True or false: Tofu can be a good source of calcium for vegetarians

true

According to recommendations from the National Osteoporosis Foundation, which of the following patients should undergo DEXA testing?

--A 47-year-old peri-menopausal woman who suffered a stress fracture in her wrist --A 63-year-old woman who takes steroids for arthritis pain

Which of the following health conditions place a person at increased risk for phosphorus deficiency?

--Alcohol use disorders --Anorexia nervosa --Diabetes

Which of the following are functions of calcium?

--Bone building --Muscle function --Blood clotting

Select ways in which a person can help prevent osteoporosis.

--Conducting weight-bearing exercise --Consuming a diet rich in calcium and vitamin D Maintaining a healthy body weight

Which of the following are characteristics of type 2 osteoporosis?

--Demineralization of cortical bone --Affects both men and women --Demineralization of trabecular bone

Adults absorb about _____ of the calcium in the foods eaten.

30%

The UL for phosphorus for young adults is ______ milligrams per day.

4000

The RDA for phosphorus for adults over age 18 is milligrams daily.

700

The average adult consumption of phosphorus is _____ the RDA.

Above

What type of environment is necessary for calcium to be absorbed into the body?

Acidic

On average, do Americans consume more or less phosphorus than they need?

More

If dietary intake is inadequate, excessive intakes of phosphorus, sodium, and caffeine may negatively impact bone mineral density.

Calcium

Which type of calcium supplement can be taken without regard to meals?

Calcium citrate

Our bodies are able to synthesize vitamin ______ from exposure to sunlight.

D

Rickets is the deficiency disease caused by the lack of vitamin

D

What is the most nutrient-dense source of calcium?

Fat-free milk, because of its high bioavailability and low calorie content.

Which of the following statements about ethnicity and bone health is true?

Individuals of Caucasian or Asian descent are at increased risk of poor bone health compared with individuals of African descent.

Who is at the greatest risk for developing osteoporosis?

Slender, inactive women who smoke

The rate of bone loss among older women is ______ the rate of bone loss among older men.

faster than

Factors that affect the ability of the skin to synthesize vitamin D include

age. skin color.

Kyphosis is

an abnormal bending of the spine.

Children with cystic fibrosis are at risk for rickets because

fat malabsorption limits absorption of fat-soluble vitamin D.

Hemopoietic stem cells are capable of developing into

blood cells.

Chronically high phosphorus intake coupled with a low calcium intake can cause an imbalance in the calcium-to-phosphorus ratio in the diet, which can contribute to

bone loss

Bones consist of

bone marrow. cortical and trabecular bone. a layer of periosteum.

Osteopenia is diagnosed when

bone mineral density is below normal.

Screening for osteoporosis includes a

bone scan.

Ultratrace minerals that contribute to bone health include

boron. silicon.

Choose foods that are good sources of phosphorus.

bran nuts eggs fish

In the process of bone remodeling, osteoclasts

break down bone tissue. release minerals into the blood.

The best way to prevent osteoporosis is to

build dense bones during the first 30 years of life and then minimize bone loss later in life.

Choose the nutrient that functions in the maintenance of cell membrane integrity, normal blood pressure, regulation of glucose concentration, and cellular differentiation.

calcium

If dietary--- intake is inadequate, excessive intakes of phosphorus, sodium, and caffeine may negatively impact bone mineral density.

calcium

Stromal cells in the bone marrow can develop into

cartilage cells. bone cells. fat cells.

During which phases of the life cycle does the rate of bone formation exceed the rate of bone loss?

childhood infancy young adulthood

Which of the following minerals does NOT play a role in bone strength?

chloride

The function of bone marrow is to

contain stem cells.

Which of the following medications are known to decrease bone mineral density?

cortisol thyroid hormone diuretics

Women lose significant bone mass after menopause due to a(n)

decrease in estrogen.

Cortical bone is

dense and compact bone.

If a person does not consume enough calcium, blood calcium levels will be maintained by

drawing calcium out of bones.

Guidelines from the National Osteoporosis Foundation recommend that all women age 65 and older and men age 70 and older undergo ______ to assess bone health.

dual energy X-ray absorptiometry

To prevent bone loss and relieve symptoms of menopause, women may need to take

estrogen therapy.

True or false: A person who does not consume adequate calcium intakes, will have less calcium in the blood.

false

True or false: Bisphosphonates are compounds that are primarily composed of carbon and phosphorus that bind to bone mineral and increase bone breaks.

false