Dietary Ca++

Question 1

. Critical times in the life cycle for Ca++ intake

Answer 1

a. Premature infants
b. Adolescence
c. After skeletal “maturity,” esp. peri-menopause
d. Pregnancy and lactation
e. Post-Bariatric Surgery

Question 2

Premature infants Ca++ needs

Answer 2

• 3rd trimester period of rapid bone mineral accretion

- preterm infants at risk for “osteopenia of prematurity”

Question 3

hormonal milieu during puberty favors what?

Answer 3

calcium absorption and bone deposition;

Question 4

T or F: ~ 50% of total adult bone mineral mass is accrued during adolescence.

Answer 4

True

Question 5

Critical stage associated with relatively high requirements, increased losses, and frequently with low intake

Answer 5

After skeletal “maturity,” esp. peri-menopause:

Question 6

Pregnancy and lactation Ca++ demand

Answer 6

physiologic responses compensate for increased Ca demand so dietary requirements are not increased

Question 7

determination of bone mineral density (BMD)

Answer 7

Genetic/intrinsic factors

Question 8

Is Ca++ absorption increased by bone mineral depletion?

Answer 8

NO, might be on test

Question 9

Most abundant mineral in the body

Answer 9

Ca++

Question 10

T or F: Lifetime low intake of dairy products associated with increased osteoporosis

Answer 10

True

Question 11

diet low in dairy & high in sodium effect on Ca++

Answer 11

Likely not positive effect

Question 12

high fruit & veg intake (& K+, Mg++ ) & bone mass

Answer 12

associated with bone mass preservation

Question 13

Ca++ supplementation in kids

Answer 13

positive impact on bone mass/density

Question 14

Exercise: weight-bearing; on bone mass

Answer 14

muscle mass directly related to bone mass

- Ca++ intake of 1000 mg/day but w/o exercise → no ↑ bone mineral density

Question 15

Ca++ DRI

Answer 15

• Increase for adolescence
• Increase for elderly to account for bone loss
• -Requirement for pregnant women do NOT increase

Question 16

How do preggos get more Ca++

Answer 16

• Lactation increases PTH and bone mass lost, but recovers after weaning. Calcitonin increases as well
• Pregnancy increases Ca++ absorption
• Higher levels of vit D in oregnancy

Question 17

Sources of Ca

Answer 17

Dairy

Question 18

Who’s at risk for Ca++ deficincy

Answer 18

Teenage girls
premature infants
adolescents
peri-menopausal women
Bariatric surgery

Question 19

Ca++ Supplements

Answer 19

• Ca Carbonate (tums): best absorbed w/ meals
• Ca citrate malate: best absorbed b/t meals
• 43% americans use supplements

Question 20

Summary of Ca intake

Answer 20

Overall most americans have adquate intake of Ca & vit D

Question 21

Ca++ absorption site

Answer 21

duodenum

Question 22

Osteoporosis

Answer 22

Reduced bone mass w/ impairment in bone structure: inc fracture risk
loss of height and distorted body shape

Question 23

Non nutritional factors associated w/ BMD

Answer 23

-Initial bone mineral density
-Hypogonadism
-Age
-Medications (GCC)
-Behavior/lifestyles:
tobacco & alcohol

Question 24

nutritional factors associated w/ BMD

Answer 24

Lifetime Ca+ intake
Vit D
Phosphorus
Mg
Vit C & K
Caffeine: increase Ca++ (easy to offset)
Protein intake: inc absorbed Ca and urine Ca (neutral/positive net efect)
Na+ (inc urine Ca++)

Question 25

DASH diet

Answer 25

May have benefits to long term bone status

Question 26

Should >50 yr take Ca++ supplements?

Answer 26

YES, associated w/ 12% reduction in fractures of all types

Question 27

Are Ca++ supplements harmful?

Answer 27

yes, increase risk of MI. Dietary intake has no risks.