Micronutrients involved in Bones and Blood Flashcards
Why Are Bones Important?
- Support for the body
- Protects our organs (ribs, skull, vertebrae)
- Support for muscles- muscles attach to bones
- Storage reservoir for calcium, phosphorus and fluoride
- Blood cells are produced in the marrow of our bones
Nutrients involved in bone health: calcium, Vitamin D, Phosphorus, magnesium, fluoride, Vitamin K
Bone Composition
- Minerals calcium & phosphorus
- Comprises majority of bone- 65%
- Crystallize to hydroxyapatite crystals → hardness of bone
- Protein fibers made of collagen
- Comprises 35% of bone
- Strength & flexibility of bone
Bone Development
Remodeling: building & breaking down of bone
- Continuously occurring in adults
- Allows for release of Ca and P in the blood
- Allows for repair of damaged areas
Bone Growth
- Determines bone size
- Begins in the womb
- Continues until early adulthood
Bone Modeling
- Determines the bone shape
- Begins in the womb
- Continues until early adulthood
Bone Remodeling
- Maintains integrity of bone
- Replaces old bone with new bone to maintain mineral balance
- involves bone resorption and formation
- occurs predominately during adulthood
Cells Involved in Bone Remodeling
- Osteoclasts: dissolve bone, resorption, “crushing”
- Osteoblasts: bone “building” cells
- Osteocytes: fully matured osteoblasts, bone cells
Phases of Bone Development Throughout Life
-Teens: bone growth achieved ~14 yo for girls & ~17 yo for boys
-Early adulthood: add bone density but max. reached by 30
~ 90% of body density reached by the age 17 for women and 20 for men
-35 & older: bone density begins irreversible decline
Calcium
-Most abundant mineral in our body
Functions:
- provide structure to bones and teeth
- acid-base balance (Ca basic)
- transmission of nerve impulse
- muscle contraction
- regulation of hormones & enzymes
- blood clotting
Calcium Absorption
- Absorption via passive & active transport (Vitamin D)
- Acidic environment
- Older adults with atrophic gastritis (~10-30% in 50s, 40% 80s), reduced HCL, consume with a meal
- ↑ absorption in times of greater need
- Absorption ~30% for healthy adults, ~60% in pregnancy, infants, children, adolescents
- ↑ intake ↓ absorption (and the reverse)
- Maximum absorption ~ 500mg at a time
- Dietary binders but not enough to cause deficiency
- Phytates (legumes, rice, grains), oxalates (spinach, teas), minerals (iron)
Blood Levels of Calcium Are Tightly Regulated
Think for a minute, how might our bodies regulate calcium?
- Storage: bones
- Excretion: kidneys
- Absorption: GI
RDA & Food Sources for Calcium
- RDA established in 2010
- 9-18 yo = 1,300 mg/day
- 19-50 yo = 1,000 mg/day
- Older men & women: 1,200 mg/d for
- Many women & adolescents are below the RDA
- Nutrient of concern in the U.S.
Calcium Toxicity
-Supplemental form
*Increase the risk of calcification of soft tissues
~Meta-analysis of 12,000 people from 15 studies found supplemental calcium (without D) increased the risk of heart attack by 30%. (BMJ. 2010 Jul 29;341)
~WHI data reanalyzed and found same association (with or without D) (BMJ. 2011 Apr 19;342)
*Mineral imbalances: iron, zinc, magnesium
*Kidney stones: calcium deposits
Calcium Deficiency
- ↓ bone density(mineralization)
- Children: stunted growth
- Adults: osteoporosis
- Low bone mass, deterioration of bone tissue
- Porous brittle fragile bones- ↓ ability to put weight on the bone
- High risk of spine and pelvic fractures
- Loss of height
- -Loss of bone in spine= compression of the spine
- Kyphosis: hunching of the spine
Factors Affecting Risk of Osteoporosis
-Genetics: family history, race (Caucasian and Asian at higher risk)
-Female gender: lower bone density, menopause, live longer
-Aging: reduced estrogen and testosterone, ↓ stomach acidity, ↓ physical activity, ↓ vit D synthesis
-Amenorrhea
-Exercise
-Body size
-Smoking: direct toxic effect on the bone
-Low peak bone mass: “A pediatric disease with geriatric consequences”
-Calcium, vitamin D intake
Emerging data: high caffeine intake (>3c coffee/d) in elderly
Management & Prevention
No cure for osteoporosis but drugs can slow or reverse somebone loss
Prevention by maximizing peak bone mass before early adulthood
- Optimal calcium & vitamin D
- Active lifestyle: weight bearing exercise- strength training, running, stair climbing
Vitamin D
-Fat soluble vitamin
-Is it essential?
*Depends where you live. If you live in a place with lots of sun, than no. But if you leave in a place that has no sun, than yes, the vitamin D is essential
-Functions
*Regulates blood calcium, what are the 3 ways it works with PTH to increase blood calcium?
~Enhance osteoclast activity (crush bones)
~Increase calcium absorption
~Increase blood calcium by signaling the kidneys to not secrete so much calcium and absorb it
*Maintain bone health
~↑ Ca absorption and
~Assists with crystallization of Ca & Phos into hydroxyapatite crystals
*Role in cancer and heart disease
RDA: Vitamin D
- 1-70 y.o.= 600 IU ->70 y.o.= 800 IU
- Many experts suggest 800-2,000 IU
- UL vitamin D is 4,000 IU
- Average intake
men: 200-288 IU Women:144-276
Vitamin D & Food
- Forms in food
- Ergocalciferol (D2) in plants (inactive form)
- Cholcalciferol (D3) in animal foods (active form)
- Fatty fish (salmon, mackerel, sardines), cod liver oil, milk, fortified dairy, fortified cereals
- 1 Tbs cod liver oil: 1,360 IU
- 3 oz sockeye salmon: 375 IU
- Tuna in oil (3 oz): 200 IU
- Total fortified cereal (3/4 c): 100 IU
- 1 c milk: 80 IU (all milk in US is fortified with vit D)
- 1c fortified yogurt: 80 IU
Sunlight & Vitamin D
Enhanced synthesis:
- June & July
- Sunny, no clouds or smog
- Latitude: closer to equator (changes at 40 deg N or S)
- 9-3 pm
- younger age
- SPF<8 (above 8 reduces synthesis)
- exposed skin (clothing blocks)
- lighter skin color
~3,000 IU from 5-10 min mid-day mid-year sun exposed on arms & legs, weight the pro against risk of skin cancer