Class 17- The Major Minerals K, Na, P & Bone Health Vit D, osteoporosis

inorganic elements are…

are NOT destroyed by heat, air, acid, or mixing

act as binders, can Impact mineral bioavailability in some foods

 Phytates and oxalates - considered anti-nutrients bc binds nutrients —> Occur in foods that are plant origin

 Excess of some mineral can create an inadequacy of another, Supplements are often to blame

what are the major minerals in human body (7)

how is potassium involved in electrolyte balance?

Intracellular cation

 High blood concentraion (cardiac arrest)

 Deficiency= Losses (vomiting and

diarrhea)

 Diuretics (for

hypertension)

what does sodium have to so with electrolyte balance?

 Extracellular cation

 Blood volume regulation

 Na K ATPase

Roles in the body:

 Fluid and electrolyte balance

 Acid–base balance

 Nerve transmission

 Muscle contraction

 Readily absorbed and travels freely in the blood

how does high blood pressure affect the body? (5 general things)

increases pressure everywhere!!

what does dash suggest to INCREASE that will help lower BP? (4)

Fibre, Potassium, Magnesium, Calcium

what are bones composed of? what does bone mineral density correspond to?

Composed of:

 65% mineral crystals—> Strength and structural support

 35% collagen—> Flexibility

BONE MINERAL DENSITY CORRESPONDS to bone strength

what are the 2 types of bone

TYPES:

cortical

• 80% of mineral structure, dense outer layer

• gives up calcium to blood

trabecular

• 20% mineral of mineral structure

• lacy bubbly structure

• impacted by day-to-day intake and need for calcium

how do bones grow?

Genetically programmed to grow in length

 Conception to teen years

 Ceases at ~14 years (girls), ~17 years (boys)

 Bone mineral density accrues at the same time into young adulthood – GOOD NUTRITION IS KEY!

Bone remodelling

 Osteoclast and osteoblast activity

 Occurs over a lifetime

 Osteoclast > osteoblast activity as we age

how do osteoblasts and osteoclasts work tg, what do they do individually? 

Osteoblasts and osteoclasts work together to form new bone cells and break down old or damaged bone tissue.

• Osteoblasts form new bone tissue.

• Osteoclasts break down old bone tissue to make room for new, healthier tissue to replace it

*osteoclast activity occurs more then osteoblast activity with age  

BONE REMOLDING: bone growth vs bone modelling vs bone remoldeling 

process of new bones being mad, old stuff getting remodelled

what are two steps of bone remolding,

1. bone resorption

• the surface of bones id broken doens

• osteoCLASTS  wil erode surface of bones

2. bone formation

• = new bone being formed after resorption

• osteoBLASTS produce collagen containing components of bone

what is osteoporosis? 

= disease that weakens bones

characterized by low bone mass & deterioration of bone tissue

• inc risk of fractures:

• ○ Hip

  ○ Spine

  ○ Wrist

  ○ Shoulder

why do some women loose height? 

caused by osteoporosis 

what  are stats of environmental VS bone density/genetic causes of osteoporosis? explain environmental influences (2)

environmental:

• CALCIUM AND VIT. D

-Bone strength in later life dependent on bone-

building during childhood and adolescence—> so good to build string bones when young!

• ESTROGEN DEFICIENCY

- Greater bone lose for women during

menopause (estrogen production diminishes –

20% bone loss 6-8 yr post menopause)

• Men have greater bone density and smaller

losses

what are some non-modifiable risk factors for osteoporosis? 

what are some example of modifiable risk factors for osteoporosis? 

what is T-score range for normal bone, osteopenia, vs osteoporosis? 

NORMAL=

t score -1 score or greater

OSTEOPENIA=

tscore= -1 to -2.5

• Bone mineral density 1–2.5 SD below the mean established for a young normal population

OSTEOPOROSIS= 

tscore >-2.5

• Bone mineral density > 2.5 SD

  below the mean established for

  a young normal population

explain bone growth team: players, coaches, assistant 

Players

protein - collagen

minerals - Ca, P, Mg, Fl

Coaches

Vitamin D, parathyroid hormone

calcitonin

Assistants/Scouts

Vitamins: A, C, K, Bs, omega 3,

phytochemicals

explain the role of phosphorus  (what does it work w and form?) and magnesium in bone

PHOSPHORUS

 working w Ca , it forms hydroxyapatite mineral of bone

 High intake decreases Ca absorption

 Typical intake is higher than RDA

MAGNESIUM

 Bone structure and regulation of mineralization, vitamin D metabolism

 ATP synthesis

 Blood clotting, muscle contraction (Ca promotes,

Mg inhibits), blood pressure regulation

roles of Vit K, A, C in bone

Vitamin K

 Co-enzyme synthesize bone protein – Osteocalcin Helps bind

minerals to bone

 if Deficiency – cannot bind minerals

Vitamin A

 Bone remodeling, osteoclast activity BUT will reduce BMD with supplements above UL…

Vitamin C

 Cofactor for collagen synthesis (organic matrix)

what does weight train do for bone density?

• Working muscles pull on bone, causing

more trabeculae and bones grow denser

• Hormones supporting muscle growth

  also support bone building

  • Bones of active people are denser and stronger than sedentary people

• Most important factor supporting

children’s bone growth

• Lasting benefits for older women

Conclusion: weight training improves

bone density… as does regular aerobic

exercise 

what is involved with osteoporosis prevention/tretament, for 1. lifestyle , 2. what meds are prescribed in medical treatment? anabolic agents? 

1. Lifestyle:

Nutrition: Ca, Vit D and..…

• Physical activity- including wt training, wt bearing exercise

• Quit smoking, decrease alcohol

2. Medical Treatment:

 Anti-resorptive agents inhibit osteoclasts, E.g. Bisphosphonates

 Hormone replacements (including SERMs eg Raloxifene)

 Anabolic agents to stimulate osteoblasts, E.g. PTH

info on calcium, where is it stored in body? 

Most abundant mineral in the body

• 99% stored in bones and teeth

• Part of bone structure(hydroxyapatite)

• Calcium reserve

• Maintain bone turnover(building/breakdown)

• 1 % in body fluids:

- Extracellular and intracellular

compartments

what is calciums roles in disease prevention?

GOOD FOR DEC.:

 Hypertension

 Blood cholesterol

 Diabetes

 Colon cancer

 Obesity

 May help maintain healthy body weight

 Osteoporosis

SO —> Reaching peak bone mass means denser bones protect against inevitable age-

related bone loss and fractures.

Osteoporosis is “silent” because the body

shows no symptoms.

smooth muscle contraction requires xxx

smooth muscle contraction requires calcium

how is calcium involved extra VS intracellular

EXTRAcellular

• helps maintain BP

• participates in blood clotting—> fibrinogen protein+ Ca+vit k

INTRAcellular

• Regulation of muscle contraction

• Transmission of nerve impulses

• Secretion of hormones

• Activation of some enzyme reactions

what happens when LOW blood calcium, what is occurs in thyroid, kidneys, intestines, bones, what is final result? 

what happens when HIGH blood calcium, what is occurs in thyroid, kidneys, intestines, bones, what is final result? 

what age group would have generally more calcitonin 

to protect agains high lvls of calcium in blood

NOTE: Calcitonin plays a major role in defending infants and young children against the dangers of rising blood calcium that can occur when regular feedings of milk deliver large quantities of calcium to a small body. In contrast, calcitonin plays a elatively minor role in adults because their absorption of Ca is less efficient and larger bodies

ACUTE VS CHRONIC calcium regulation

ACUTE

 Blood Ca MUST be maintained

 tetany/rigor

 ↑ ↓ blood Ca is a problem of regulation NOT DIET

CHRONIC

 low dietary Ca - robs the “bone RRSP”

i.e. ↓ bone mineralization

 stunting in children

 osteoporosis

low calcium diet vs adequate calcium diet affects on: blood calcium vs affect on bones

what are some Ca absorption factors? inc vs dec

absorption increased by:

 anabolic hormones

 gastric acid (meal)

 vitamin D

 low phosphate intake

 lactose (in infants only

absorption dec by:

 aging

 lack of stomach acid

 vitamin D deficiency

 high phosphate intake

 high insoluble fibre diet

 phytates, oxalates

 high protein intake

what is urinary calcium excretion influenced by?

 Calcium intake

 Age

 Caffeine BUT Offset by milk in your coffee

 Dietary sodium—> Individuals with hypercalciuria should be restrict sodium intakes to minimize urinary calcium excretion

 Dietary protein—>Excretion of sulphate from sulphur amino acids

what can calcium toxicity lead to?

constipation, interferes w other minerals absorption, increase risk of kidney stone formation

• Compromised Iron Status (and other minerals) Ca inhibits absorption

• Milk Alkali Syndrome (metabolic alkalosis and renal failure)

• Kidney stones

• Vitamin D toxicity and increased serum Ca if supplements contain vitamin D

• exposure to contaminants if supplements are from bone meal or dolomite

how can Vit D be absorbed from sun vs diet?

what are some vit D functions?  what is active form? 

Active form is a hormone- Essential for making and maintaining bones

• Required for calcium and phosphorous absorption (calbindin)

• Regulates blood calcium and levels

• Stimulates osteoclasts

• Necessary for bone calcification

New functions: immunity and cell differentiation

• Brain and nerve cells, protects against cognitive

decline

• Adipose cell regulation

is vitamin D a hormone or a vitamin? why?

BOTH

AS A HORMONE BC: 

• Travels in the blood

• Activated in the liver and

kidneys

• Acts on intestine, kidney,

bones...

• to increase Ca availability

for bone mineralization

and remodeling

AS A VIT BC:

It is essential in the diet

• performs a specific function

• absence results in

deficiency

• We can’t synthesize as much

as we need

• Vitamin is activated to a

hormone

what are some factors the reduce how much vit D your body makes? 

Limited sun exposure

 Sunscreen use Or little skin exposure to sun

 Living at a high latitude (most of Canada)

 Staying indoors

 Cloud cover, smog

 Dark skin: people with darker skin absorb less of the sun's ultraviolet

rays

 Age, especially if >65y…

 Digestion issues – eg: Crohn's or celiac disease, bariatric surgery

 Liver and kidney disease

what is vit D deficiency vs toxicity symptoms?

Deficiency:

- Abnormal bone growth (rickets in children;

osteomalacia or osteoporosis in adults)

- Malformed teeth

- Muscle spasms

Toxicity:

- Elevated blood calcium

- Calcification of soft tissues

- Excessive thirst

- Headache

- Nausea

- Weakness

what are some vit D sources 

magnesium: storage, roes, UL?

• more then ½ Mg storage = in bones, as a reservoir to ensure normal blond conc.

ROLES:

 Maintains bone health

 Energy metabolism and ATP production

 Inhibits muscle contraction and blood clotting

 Blood pressure – dietary intake protective, Critical to heart function

 Supports normal function of immune system

Deficiency rare – d/t inadequate intakes

 Impairs central nervous system activity, circulatory system

UL: 350 mg ….for supplements not foods