Ch. 11 Nutrients Involved in Bone Health LS

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

Phosphorus (In contrast to calcium, phosphorus is naturally abundant in many foods and beverages.)

type 2 osteoporosis

Porous trabecular and cortical bone observed in men and women after the age of 70. tends to be diagnosed later in life (70 to 75 years of age). Type 2 osteoporosis is a result of breakdown of both cortical and trabecular bone. It is due to a combination of dietary and age-related factors; low dietary intake of bone-building nutrients compounds the problems resulting from the decreased ability to absorb or metabolize nutrients.

type 1 osteoporosis

Porous trabecular bone characterized by rapid bone demineralization following menopause. There are two types of osteoporosis. Type 1 osteoporosis, also called postmenopausal osteoporosis, typically appears in women between 50 and 60 years of age. This type of osteoporosis is directly linked to decreased estrogen concentrations that occur at menopause. Type 1 osteoporosis most dramatically affects trabecular bone, as this type of bone undergoes faster remodeling than cortical bone

calcium RDA

RDA of 1000 mg per day for young adults

RDA of magnesium

RDA of 310 mg per day for young women and 400 mg per day for young men

stuff about hip fractures

STATS: Hip fractures are regarded as devastating. They often result in loss of mobility and the need for long-term care. Women experience 80% of hip fractures, and the average age for hip fracture is 80 years.18 Only 40% of people with hip fractures regain their earlier level of independence. It is estimated that a year after fracturing a hip, 90% of those who needed no assistance climbing stairs before the fracture will not be able to climb five stairs; 66% will need help to get on or off a toilet; 50% will not be able to raise themselves from a chair; 31% will need assistance to get out of bed; and 20% will not be able to put on a pair of pants by themselves. Hip fracture is associated with significant mortality. It is estimated that 20% to 30% of the 300,000 Americans age 65 or older who fracture a hip each year will die within 12 months. Other types of fractures or even fear of fracture due to osteoporosis can affect quality of life. Vertebral fractures, especially if there are several of them, cause significant pain, reduced lung function, loss of height, and a curved spine. Movement can be restricted and gait altered, increasing the risk and fear of falls and/or more fractures.

The results of DEXA measurements are known as

T scores

define cortical bone

The compact or dense bone found on the outer surfaces of bone. Cortical bone is sometimes called dense or compact bone. It comprises 80% of adult bone mass. The outer portion of nearly all bones is composed of dense, strong, cortical bone. The principal function of cortical bone is to provide strength and stability. Microscopic openings in cortical bone allow blood vessels and nerves to pass through, supplying nutrients, oxygen, and hormones to bone cells.

influence of estrogen

The hormone estrogen, produced by the ovaries in women and by adipose tissue in both men and women, is a major contributor to bone maintenance. Estrogen has been shown to stimulate osteoblast activity (bone formation). Low estrogen levels are a major factor in the decline of bone mass and bone mineral density observed among women who experience menstrual irregularities (i.e., no menstrual period for 3 consecutive months) and after menopause. For this reason, any menstrual irregularity—especially when coupled with disordered eating—should be brought to the attention of a primary care provider. Other biological factors include frame size and race

MATCHING GAME IN CLASS: rickets disease

a softening and weakening of bones in children

The likelihood of exceeding the UL for calcium is lowest when the source of the mineral is

a varied, balanced diet (likelihood of exceeding the UL for calcium is highest when source of the mineral is calcium citrate supplements, calcium carbonate supplements, or heavy use of fortified foods.)

which of the folloiwng is the best source of magnesium?

beans (not eggs, cheese, or pork Magnesium is found in the plant pigment chlorophyll, so rich sources of magnesium are plant products, such as squash, whole grains (such as wheat bran), beans, nuts, seeds, and broccoli (Fig. 11-14). Animal products (e.g., milk and meats) and chocolate supply some magnesium, although not as much as foods of plant origin. Another source of magnesium is hard tap water, which contains a high mineral content.

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

bone

which of the following are functions of calcium?

bone building blood clotting muscle function Calcium (Ca) represents 40% of all the minerals present in the body and equals about 2.5 pounds (1200 grams) of body weight in the average person. All cells require calcium to function; however, more than 99% of the calcium in the body is used for growth, development, and maintenance of bones. Calcium is the main component of hydroxyapatite, the crystalline compound responsible for the structure and hardness of bone.

define bone marrow

bone marrow The spongy tissue in flat bones and trabecular bone that contains stem cells.

Forming and maintaining ______ are calcium's major roles in the body.

bones

MATCHING GAME IN CLASS: osteopenia

bones with low mineral density

When habitual intake of vitamin D exceeds the UL, health risks include

calcium deposits in organs gastrointestinal distress Due to the role of vitamin D in calcium absorption, excretion, and release of calcium from bone, supplementation with high doses of vitamin D can cause calcium levels in the blood to increase above the normal range. The UL of 100 micrograms is based on the risk of overabsorption of calcium and eventual calcium deposits in the kidneys and other organs. Calcium deposits in organs can cause metabolic disturbances and cell death. Toxicity symptoms also include weakness, loss of appetite, diarrhea, vomiting, mental confusion, and increased urine output. Please note that vitamin D toxicity does not result from excessive exposure to the sun because the body regulates the amount made in the skin (i.e., as exposure to sunlight increases, the efficiency of vitamin D synthesis decreases). .

MATCHING GAME IN CLASS: osteoclast

cell that promotes bone breakdown

MATCHING GAME IN CLASS: osteoblast

cell that promotes bone formation

A person with intolerance to lactose may have to follow a _____ free diet

dairy; so they must ensure that they meet all their nutritional needs, esp calcium and phosphorus

Incorporation of fluoride into the tooth structure during tooth development limits

demineralization by acid-producing bacteria

low levels of fluoride increase the risk of

dental caries

magnesium toxicity leads to

diarrhea

Hip fractures are particularly devastating because they often result in

disability loss of independence mortality (NOT kyphosis directly; kyphosis is curvature of the spine resulting from vertebral fractures, not hip fractures; both vertebral and hip fractures are at increased likelihood if have osteoporosis tho)

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

drawing calcium out of the bones (this is why having a chronic calcium deficiency is bad, because the osteoclast are continually active at degrading ur bone so that u have enough calcium floating around in your bloodstream)

Low levels of the female reproductive hormone are detrimental to bone health because this hormone stimulates osteoblast activity. (This question is asking for a hormone, not a vitamin or mineral.)

estrogen

With an AI of 3.1 to 3.8 mg/day, ______ is a trace mineral that contributes to bone health.

fluoride AI: 3.1 to 3.8 milligrams UL: Young children: 1.3 to 2.2 milligrams > 9 years: 10 milligrams

Exceeding the UL for ______ can lead to hip fractures, still joints, and stomach inflammation among adults.

fluoride In adults, fluorosis is associated with hip fractures, weak or stiff joints, and chronic stomach inflammation.

functions of fluoride include

helping teeth resist acids blocking growth of bacteria mineralizing tooth enamel (NOT whitening of teeth; Fluoride may be used alongside tooth-whitening treatments to prevent breakdown of enamel, but fluoride itself does not whiten the teeth.)

Osteoporotic fractures of the ______ lead to the worst outcomes, including long hospital stays, permanent disability, and even death.

hip

Vitamin D is unique in that it has a site of synthesis that is different from the location of action, so it is considered to be a

hormone

Magneisum Deficiency can cause

irregular heartbeat

which of the following are potential outcomes of excessive calcium intakes?

kidney failure kidney stones calcification of soft tissue Upper Level (UL) for calcium intake is 2500 milligrams per day for young adults, based on the observation that greater intakes increase the risk for some forms of kidney stones. Excessive calcium intakes by some people can also cause high blood and urinary calcium concentrations, irritability, headache, kidney failure, soft tissue calcification, and decreased absorption of other minerals.

calcium toxicity may cause

kidney stones, headaches, irritability, and soft tissue calcification.

The DEXA technique uses ______ to measure bone mineral density.

low-level x-rays most accurate test for assessing bone density is the central dual energy X-ray absorptiometry (DEXA) measurement of the hip and spine. The central DEXA procedure is simple, painless, safe, noninvasive, and generally takes less than 15 minutes. The ability of the bone to block the path of a low-level X-ray is used as a measure of bone mineral density. A very low dose of radiation is used for the DEXA—about one-tenth of the exposure from a chest X-ray. The hip and spine are measured because these sites are commonly affected by osteoporosis and are likely to result in more serious injuries. From the DEXA measurement of bone density, a T-score is generated, which compares the observed bone density to that of a person at peak bone mass (e.g., age 30). The T-score is interpreted as shown in

Irregular heartbeat, weakness, and muscle pain are symptoms of a ______ deficiency.

magnesium In humans, a magnesium deficiency causes an irregular heartbeat, sometimes accompanied by weakness, muscle pain, disorientation, and seizures.

Potassium and ______ supplementation can decrease blood pressure.

magnesium (magnesium and potassium have similar effects in the body; sodium can increase BP, chloride is associated with increased blood pressure, prolly cuz table salt consists of sodium and chloride ions)

Highly trained athletes are at risk for bone loss if

menstruation becomes irregular or ceases altogether. (cessation of menstrual periods signal low estrogen levels, which are detrimental to bone health) *increased production of vit D is beneficial for bone health *the stress of strength traiing helps to build bone *stretching protects muscles from injury, but is not primarily associated with bone health

Bones consist of:

-cortical and trabecular bone -bone marrow -a layer of periosteum *teeth have enamel, but bones do NOT

Among typical Americans, deficiencies of phosphorus are

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

Type ____ osteoporosis occurs in women after menopause due to the rapid decline in estrogen production.

1

Rank the following food sources from lowest (at the top) to highest (at the bottom) magnesium content.

1. whole-wheat bread, 1 slice 2. banana, 1 medium 2. plain yogurt, 1 cup 4. spinach, 1 cup Food sources of magnesium. (a) The fill of the background color (none, 1/3, 2/3, or completely covered) within each food group on MyPlate indicates the average nutrient density for magnesium in that group. (b) The bar graph shows the magnesium content of several foods in each food group compared to the RDA for adult males and females. Overall, the richest sources of magnesium are vegetables and whole grains.

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

30% (during infancy and pregnancy, absorption increases to as high as 60%)

calcium absorption

Adults absorb about 30% of the calcium in the foods eaten, but during times when the body needs extra calcium, such as in infancy and pregnancy, absorption increases to as high as 60%. The normal aging process negatively influences the absorption efficiency of calcium. Due to decreased synthesis, absorption, and activation of vitamin D, as well as decreased acid secretion in the stomach, people over age 40 have a harder time meeting their needs for calcium

phosphorus deficiency

Although extremely rare, symptoms of phosphorus deficiency include loss of appetite, anemia, muscle weakness, bone pain, fragile bones, increased susceptibility to infection, numbness and tingling of the extremities, difficulty walking, and irregular breathing

anemia results from

Anemia most often results from low levels of iron, copper, folate, vitamin B-12, or vitamin B-6.

define trabecular bone

Bone that is less dense, with a more open structure; found in the inner layer of bone. Trabecular bone is predominant in the ends of long bones, vertebrae, rib cage, and flat bones of the pelvis. About 20% of adult bone mass is trabecular. Trabecular bone provides even more strength and structural stability. Because it is spongy and less rigid, it acts more like a shock absorber. It has an open structure, which lightens the weight of bones. The latticelike matrix of trabecular bone has small cavities that can be filled with marrow or connective tissue.

Adequate dietary intake of magnesium is associated with decreased risk of

CV disease and type 2 diabetes Beyond its role in bone health, magnesium is important for nerve and heart function, and aids in many enzyme reactions. Other possible benefits of magnesium in relation to cardiovascular disease include decreasing blood pressure by dilating arteries and preventing heart abnormalities. People with cardiovascular disease should closely monitor magnesium intake, especially because they are often on medications, such as diuretics, that reduce magnesium levels. A dietary pattern that includes food sources that are rich in magnesium and calcium is associated with lower risk of type 2 diabetes in some populations.

vitamin D toxicity may cause

Calcification of soft tissue, weakness, GI distress, and mental confusion

Rickets is the deficiency disease caused by the lack of vitamin

D Vitamin D deficiency causes rickets, in which the bones and teeth do not develop normally. This young man has bowed legs and other skeletal deformities of rickets.

fluorisis

Discoloration of tooth enamel sometimes accompanied with pitting due to consuming a large amount of fluoride for an extended period. Children may develop fluorosis if they swallow large amounts of fluoride toothpaste as part of daily tooth care. Fluorosis leads to stained and pitted teeth and can permanently damage teeth if it occurs during tooth development (first decade of life) (Fig. 11-15). Not swallowing toothpaste and limiting the amount used to "pea" size are the best ways to prevent this problem. In addition, children under 6 years should have tooth brushing supervised by an adult and should never use fluoride mouthwash

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

FALSE (the body will remove calcium from the bones in order to maintain correct serum calcium levels

True or false: The low absorption, plus the limited availability of phosphorus in foods, makes this mineral more important than calcium in diet planning.

FALSE correction: The high absorption, plus its wide availability in foods, makes this mineral less important than calcium in diet planning.

True or false: Phosphorus deficiency is a very serious and relatively common concern.

FALSE (no disease is currently associated with an inadequate phosphorus intake) Deficiencies of phosphorus are unlikely in healthy adults because it is widespread in food and beverages, and efficiently absorbed. Dietary phosphorus deficiency usually occurs only in cases of near-total starvation, including anorexia nervosa. Some health conditions, such as diabetes and alcohol use disorders, as well as medications, such as antacids and diuretics, can cause body phosphorus levels to fall

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

False (The body will remove calcium from the bones in order to maintain correct serum calcium levels.)

functions of fluoride

Fluoride functions in the following ways to prevent dental caries: (1) incorporates into tooth structure, causing it to be stronger and more resistant to acid degradation from bacteria found in plaque; (2) stimulates remineralization of enamel and inhibits tooth demineralization; and (3) has antibacterial effect on acid-producing microorganisms found in plaque.

RANDOM NOTES AB LOW LEVELS OF VIT D

Low levels of vitamin D have been linked to risk for autoimmune disorders, such as type 1 diabetes. Low levels of vitamin D affect absorption of calcium and phosphorus, which leads to poor bone mineralization.

magnesium functions

Magnesium (Mg) has many functions, some of which are related to bone health. Magnesium is similar to calcium and phosphorus in that most of the magnesium in the body is found in bones. Bone contains 60% of the body's magnesium. Magnesium in bones provides rigidity, and it functions as a storage site that can be drawn upon by other tissues when dietary intake is inadequate. Magnesium is also required for the synthesis of vitamin D in the liver. It also promotes resistance to tooth decay by stabilizing calcium in tooth enamel. Magnesium functions to relax muscles after contraction. Over 300 enzymes use magnesium, and many energy-yielding compounds in cells require magnesium to function properly (e.g., ATP). Magnesium plays a critical role in the synthesis of DNA and protein possible benefits of magnesium in relation to cardiovascular disease include decreasing blood pressure by dilating arteries and preventing heart abnormalities.

Vitamin D toxicity is most likely to result from

overuse of supplemental vitamin D.

MATCH each component of bone with it's function:

periosteum-->thick membrane that covers the bone surface cortical bone-->dense bone tissue that provides strength and stability trabecular bone-->lattice-like bone tissue that acts to absorb shock bone marrow-->spongy bone tissue that contains stem cells

Active vitamin D enhances the absorption of calcium and

phosphorus

Found mostly in bone, ______ is the second most abundant mineral in the body.

phosphorus Approximately 85% of phosphorus is found as a component of hydroxyapatite crystals that provide the functional component of bone and teeth. The remaining 15% of phosphorus is in the soft tissues, blood, and extracellular fluid

active vitamin D increases intestinal absorption of

phosphorus and calcium The main function of vitamin D (calcitriol) is to maintain the normal range of calcium and phosphorus in the blood. Together with the hormones parathyroid hormone (PTH) and calcitonin, vitamin D closely maintains blood calcium in a narrow range

MATCHING GAME IN CLASS: osteoporosis type 2

porous trabecular and cortical bones observed in men and women after 70 years of age

MATCHING GAME IN CLASS: osteoporosis type 1

postmenopausal osteoporosis

Absorption of calcium is increased during...

pregnancy and infancy (absorption of calcium and other minerals typically declines with age.)

______ 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

high levels of ingested fluoride can lead to

skeletal damage tooth mottling (NOT tooth decay or white teeth!) mottled enamel a chronic endemic form of hypoplasia of the dental enamel caused by drinking water with a high fluoride content when a child is in the time of tooth formation. It is characterized by defective calcification that gives a white chalky appearance to the enamel, which gradually undergoes brown discoloration.

MATCHING GAME IN CLASS: osteomalacia

softening of the bones in adults

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

strength training *Water exercises provide cardiovascular benefits without stressing joints, but stress on the bones actually increases bone mass. *Flexibility is important for preventing muscle injuries, but weight-bearing physical activity provides the most benefit for bone health. *Cycling provides cardiovascular benefits, but weight-bearing activities are best for bone health.

consequences of calcium deficiency

tetany and low bone mineral density

Exercise is beneficial for bone health because

the additional stress on bone increases bone mineral density. *Decreased estrogen among highly trained athletes actually limits osteoblast activity, leading to bone loss. *exercise does not affect mineral absorption *lower body weight is actually a risk factor for poor bone status.

What type of nutrient is fluoride?

trace mineral The fluoride ion (F−) is the form of this trace mineral essential for human health.

iron is a

trace mineral that contributes to BLOOD health, not bone health

match type 1 and 2 osteoporosis with its def:

type 1 osteoporosis: porous trabecular bone in women that occurs following menopause type 2 osteoporosis: porous trabecular and cortical bone in men and women that occurs after age 70

______ refers to low bone mineral density that occurs in both men and women after age 70

type 2 osteoporosis

Select all that apply What are some reasons an individual may choose to avoid dairy products?

vegan diet avoid antibiotics and hormones milk protein allergy lactose intolerance (NOT celiac disease, bcuz People with celiac disease must avoid gluten, a protein found in wheat, barley, and rye; not lactose) There are many reasons why you may choose to avoid dairy products. These include following a vegan dietary pattern or just trying to increase your consumption of plant-based foods and beverages. You may have heard that a dairy-free diet will lessen your digestive problems or increase weight loss. Or you may need to avoid dairy products because you have an allergy to milk protein or intolerance to lactose. Whatever the reasons for avoiding milk and other dairy products, you must understand the nutritional implications, especially related to bone health. The typical American dietary pattern relies on dairy products to provide several essential nutrients, including protein, calcium, potassium, and vitamin D. If you do not eat dairy products, it is critical that you know how to make healthy food substitutions to get the nutrients you need

Which of the following bone-building nutrients is classified as a hormone?

vitamin D