12: Nutrition and Bone Health
- Page ID
- 98155
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)In this chapter, we delve into nutrients important for bone health. First, we explore the structure and function of bones, and then calcium, vitamin D, phosphorus, magnesium, fluoride, and vitamin K. A look at osteoporosis and at supplements rounds out this chapter.
- 12.1: Chapter Introduction
- Over two hundred million women worldwide suffer from osteoporosis. Statistics also show that one in three women and one in five men over sixty will experience an osteoporotic fracture. How can you prepare yourself and fortify your bones against this disease? Milk is a ready and convenient source of calcium and vitamin D, but one glass of milk per day is not sufficient to provide adequate intake of these nutrients and many people have an allergy or intolerance to dairy products.
- 12.2: Bone Structure and Function
- The skeleton is composed of connective tissues including bones, cartilage, tendons, and ligaments.Bones are made up of a periosteum that surrounds compact bone, which in turn surrounds trabecular bone. Bone marrow resides within the trabecular bone. Bone tissue cells are osteoprogenitor cells, osteoblasts, osteoclasts, and osteocytes. Bone is a living tissue that adapts to mechanical stress via the remodeling process.
- 12.3: Bone Mineral Density is an Indicator of Bone Health
- Bone-mineral density is a measurement of calcified bone tissue and positively correlates with overall bone health. DEXA is a clinical tool used to assess BMD.
- 12.4: Micronutrients Essential for Bone Health- Calcium and Vitamin D
- Calcium is the most abundant mineral in the body and has four primary functions: making bones strong and healthy, facilitating nerve-to-nerve communication, stimulating muscle contraction, and activating blood-clotting factors. Other benefits of calcium in the body include decreasing blood pressure and preventing colon cancer. Calcium blood-levels are rigorously controlled by three hormones: PTH, calcitriol, and calcitonin. The DRI for calcium intake for adults averages from 1,000–1,200 mg/day.
- 12.5: Other Essential Micronutrients for Bone Health
- Phosphorous is a primary mineral component of bone, is regulated in parallel with calcium, and in high amounts is detrimental to bone health. Magnesium helps keep bones strong. A deficiency in magnesium can compromise bone health. Fluoride combats tooth decay and benefits teeth and bones when present in the diet at the recommended intake. Vitamin K is a coenzyme that participates in the modification of proteins that act in bone tissues and promotes normal blood clotting.
- 12.6: Osteoporosis
- Bone mineral density (BMD) is an indicator of bone quality and correlates with bone strength. Excessive bone loss can lead to the development of osteopenia and eventually osteoporosis. Osteoporosis affects women more than men, but is a debilitating disease for either sex. Osteoporosis is often a silent disease that doesn’t manifest itself until a fracture is sustained.
- 12.7: Risk Factors for Osteoporosis
- Nonmodifiable risk factors for osteoporosis include: being female, being over age fifty, having a small frame, having an endocrine disorder, having a family member with the disease, and being Caucasian or Asian. The risk factors for osteoporosis that can be changed are: smoking, alcohol intake, physical inactivity, and poor nutrition. Dietary inadequacy, certain medications, and diseases increase the risk for developing osteoporosis.
- 12.8: Osteoporosis Prevention and Treatment
- Osteoporosis is a childhood disease with old-age consequences. Primary prevention of osteoporosis begins early in life with proper diet and exercise. The strategies of secondary prevention that focus on treating osteoporosis aim to arrest further bone loss and reduce fracture risk. Osteoporosis prevention and treatment involves a three-tiered approach that incorporates lifestyle modifications, the assessment and treatment of underlying causes of the disease, and pharmacotherapy.
- 12.9: Deficiency, Supplementation, and Choices
- The groups of people who are most at risk for calcium inadequacy are adolescent teens, amenorrheic women, the female triad athlete, the elderly, lactose-intolerant people, those with milk allergies, and vegans. When taking calcium supplements, be sure to monitor vitamin D intake to ensure that the proper benefits are achieved. Split doses are more effective since the gastrointestinal tract can only absorb up to 500 milligrams at one time.