HNF260-Exam2StudyGuide.pdf HNF 260
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Date Created: 09/27/15
PreExam Review Exam 2 Chapter 5 Lipids AMDR 2035 of daily calories Energy 9 kcalgram No more than 10 of energy from polyunsaturated fatty acids Limit saturated fats lt10 of energy Keep trans fats as low as possible lt 300 mg cholesterol intake omega6 n6 5 of kcal omega3 n3 06 to 12 of kcal Triglycerides o Glycerol plus 3 fatty acids 0 Roles Energy storage in fat cells Insulate bodycushion organs Aid in absorption and transport of fatsoluble vitamins Fatty acids 0 Understand saturated monounsaturated polyunsaturated FA 0 Understand cis and trans isomers and that trans isomers arise from partial hydrogenization of oils 0 Trans fat health issues raises LDL lowers HDL Bad 0 Essential Fatty acids Omega 6 linoleic acid Omega 3 alphalinolenic acid 0 Recognize the differences in composition of some commonly consumed oils such as olive oil coconut oil corn oil monounsaturated polyunsaturated saturated Phospholipids o Hydrophilic head hydrophobic tail 0 ln cell membranes micelles 0 Not an essential nutrient we can make our own phospholipids from other compounds 0 Lecithins in eggs used for emulsi cation in cooking Sterols 0 Cholesterol comes from animalbased foods not plants 0 Plants make some other types of sterols 0 We make our own cholesterol in the liver so not a dietary essential 0 Cholesterol is a precursor for steroid hormones bile acids vitamin D 0 Be familiar with highcholesterol foods eggs very high in cholesterol Lipid digestion 0 Review info on slides Lipases digest triglycerides Bile emulsi es fats Understand what emulsi cation is and why it aids fat digestion Lipid absorption 0 Review info on slides Fatty acids and monoglycerides are absorbed Review what happens to short medium and long chain FA different fates after absorption short and medium chain go into bloodstream and then to liver lnside absorptive cell Triglycerides are reformed from the longchain fatty acids and monoglycerides Triglycerides are then packaged with cholesterol and protein into chylomicrons ljlymphatic system D join blood stream deliver triglycerides to cells requiring them 0 Understand what a lipoprotein is o Chlylomicron Created in the enterocyte absorptive cell of SI Function deliver triglycerides to cells in the body Chylomicrons are cleared from blood within 10 hours after a meal Fasting lipid pro le blood draw should have no chylomicrons for accuracy Receptors present on target cells Lipoprotein lipase brings lipid into target cell 0 VLDLs Also deliver triglycerides to cells Created in liver from triglycerides cholesterol protein Become LDLs after giving up their triglycerides Rich in cholesterol Function deliver cholesterol to target cells Receptor proteins on target cells Entire LDL particle is taken in by target cell via endocytosis excess LDL particles remain in blood D get oxidized D macrophages consume oxidized LDL D form arterial plaques LDL quotBadquot cholesterol high levels are associated with cardiovascular disease HDL quotGoodquot cholesterol Function scavenges cholesterol from dying cells Helps to excrete cholesterol from body Blocks oxidation of LDL o Fasting serum Lipid pro les blood draw Know the targets for total cholesterol below 200mgdl LDLbeow 100 HDL above 40 triglycerides below 100 0 Essential Fatty acids Used to produce eicosanoids roles of eicosanoids in immune response blood pressure and blood clotting Omega 3 D EPA DHA Omega 6 D arachidonic acid Desired ratio of Omega 6 to Omega 3 510x we get lots of Omega 6 not enough Omega 3 Omega 3 cold water sh ax canola Omega 6 vegetable oils Chapter 6 Proteins AMDR 1035 of daily calories RDA 08 gramskg of ideal body weight body builders athletes may double beyond that is wasted Energy 4 kcalgram Protein Linear chain of amino acids 20 different amino acids 9 essentiaamino acids body cannot produce Transamination NH2 group transfer to create nonessential amino acids from other amino acids Deaminination NH2 group removal rst step in breakdown of excess amino acids for energy Animal proteins vs plant proteins Animal protein is complete Contains all essential amino acids Plant proteins are often incomplete Missing key essential amino acids Grains low in lysine and threonine Beans low in methionine Corn low in lysine and tryptophan Complementary proteins Grains Beans served together give complete protein Digestibility Plant proteins less digestible than animalsource protein Protein Digestibility Corrected Amino Acid Score used to calculate amounts of protein on nutrition facts labels Egg white protein is the most digestible Protein turnover Reuse of amino acids from proteins that are being broken down in body Amino acids are recycledreused Much more is recycled in a day than ingested in a day Digestion of protein in body Cooking denatures proteins Stomach acid denatures proteins Gastrin hormone causes pepsinogen to be secreted in stomach stomach acid activates it to pepsin active enzyme Protein digestion by pepsin begins in stomach Chyme moves to SI CCK hormone causes pancreas to release trypsin chymotrypsin carboxypeptidase which all digest protein Proteins are digested to a mixture of free amino acids and di or tripeptides free amino acids and di or tripeptides absorbed in SI peptides broken down fully to free amino acids inside absorptive cells amino acids go to portal vein to liver to bloodstream Functions of proteins Amino acids for synthesis of new proteins enzymes hormones muscle etc Fluid balance Edema from insuf cient protein in diet Nitrogen balance Positive balance eating more than excreting growth pregnancy healing post illness building or repairing muscle Negative balance excreting more than eating breaking down and using muscle sickness bed rest Excess protein is converted to energy or stored as fat no bene t to very high protein diet High protein diets tax kidneys deamination creates lots of urea lmbalances can be caused by supplementing individuaamino acids Can affect absorption of the other amino acids and create a de ciency in one of the essential amino acids Food allergens soy wheat shell sh tree nuts milk sh peanuts eggs De ciency diseases Kwashiorcor protein de cit often due to incomplete protein unvaried diet edema Marasmus severe protein and energy de cits skeletal appearance Protein de cits can occur in the elderly Chapter 12 Fatsoluble Vitamins Absorption of fatsoluble vitamins Stomach vitamins begin to be released from food breakdown of food denaturing of proteins Sl digestive enzymes produced by the pancreas further release vitamins from food Bile from liver helps in absorption of fatsoluble vitamins Absorbed in SI with fat packaged into chylomicrons l lymph system bloodstream Chylomicrons return to liver vitamins repackaged into other lipoproteins for further delivery around body Excess A D E not easily excreted Excesses usually stored in liver or adipose tissue Toxicity Vitamin A most toxic Vitamin D may be toxic if highdose supplements taken regularly Vitamin A De ciency is leading cause of nonaccidental blindness in children Public health issue in developing countries Supplementation through Yellow genetically engineered rice high in beta carotene 0 Retinoids 6575 of diet intake of Vit A These are the active forms of vitamin A aka quotpreformedquot Vitamin A Retinal retinol and retinoic acid each have different roles in body conversion between these three active forms Conversion to retinoic acid is irreversible Animal sources liver sh eggs forti ed dairy also forti ed cereals Wellabsorbed Retinyl esters Fatty acid bound to a retinoid Chylomicron l lymphatic system blood l liver Not active until FA removed Retinoic acid Absorbed via speci c carrier proteins FA attached l chylomicron l lymphatic system blood l liver Retinoids stored in liver released into blood as needed on a retinol binding protein Can store a 1 year supply in liver Mostly retained small amounts excreted in urine 0 Carotenoids pigments in fruits and vegetables aka quotProvitamin Aquot Three carotenoids alphacarotene betacarotene and beta cryptoxanthin can be converted to biologically active Vit A retinoids Dietary sources dark green and yelloworange vegetables and fruits Poorly absorbed Excess excreted in bile Conversion of a fraction of carotenoids to retinal or retinoic acid happens in SI absorptive cells Conversion is inef cient Conversion of bulk of carotenoids to retinoids happens in liver A fraction of the carotenoids ingested are absorbed directly into bloodstream 0 Retinol activity equivalents 12 pg beta caroteine yields lug of retinol Alphacarotene and betacryptoxanthin are less ef ciently converted 241 ratio RDA most people meet it preschool children or people with fat malabsorption disorders could be de cient Vitamin A functions Embryonic development Bone remodeling Gene expression Cell differentiation turning genes on and off during development Vit A affects many genes Vision opsinrhodopsin cycling 11cis Retinal binds to opsin to form rhodopsin Night blindness early de ciency symptom Immune function Carotenoids also can function as antioxidants 0 Vitamin A de ciencies Night blindness Xerophthalmia scarring of cornea l irreversible blindness Keratinization of soft tissues skin mucous membrane of eye Retarded growth Reduced immune function 0 Vitamin A toxicity Liver damage Weakening of bones Teratogenic damaging to fetus Supplements Acne medications Accutane Carotenoids are not toxic Vitamin D 0 Synthesized in the skin when exposed to sunlight from UVB radiation possible for adults to synthesize required amounts with moderate exposure of skin to sun acts as a hormone meaning made in one place in body acts in another place in the body Vitamin D3 is formed in skin from a cholesterol precursor Sunlight changes 7dehydrocholesterol to cholecalciferol Travels to vi and then kidneys where converted to bioactive form calcitriol through 2 steps Requirement sunlight 23 timesweek for 1015min Aging reduces D3 production by 75 at age 70 Skin pigmentation also reduces D3 production SPF 8 or higher prevents Vitamin D3 production Northern climates no Vit D synthesized in the winter 0 Vitamin D3 and some D2 are also obtained from foods Fatty sh cod liver oil forti ed dairy products and some forti ed breakfast cereals or supplements 0 RDA is based on getting no exposure to sunlight Chlylomicron transport to fatty tissues and liver 0 Activation of Vitamin D proVitamin D3 and D2 not active Liver converts to 25OH Still not active Levels can be measured in blood 15day half life Kidneys convert to active form 125OH Calcitrol Very short halflife 15 hours can39t measure accurately Quickly used Transport by Vitamin D binding protein Excretion in bile small amount urine 0 Relationship to Calcium levels Parathyroid glands respond to a shortage of calcium in the blood by producing parathyroid hormone PTH PTH stimulates the kidney to produce 125OH vitamin D Active vitamin D increases calcium absorption from small intestine Calcitonin is activated when blood Ca levels rise Stops PTH decreasing Vitamin D activity Prevents blood Ca from rising too high Look at Figure 1214 understand this regulation 0 Vitamin D de ciencies Children rickets Inadequate mineralization Ca P of bone Bowed legs Enlargement of ends of long bones Adults osteomalacia softening of bones Impaired bone remineralization not the same as osteoporosis Softening of the bone bending of spine Occurs most often in women Multiple pregnancies Elderly Little exposure to sunlight nursing home During Vitamin D De ciency VERY LITTLE CALCIUM ABSORPTION So despite normal Ca intake bones become undersupplied 0 Vit D Toxicity Comes from excess supplementation Hypercalcemia gt calcium deposits in soft tissue Kidney stones Ca deposits Hardening of blood vessels Vitamin E Tocopherols and Tocotrienols Alpha tocopherol is the most active Sources Plant oils and whole grains Animal fats and dairy have little Vit E Vit E damaged by heat oxidation deepfrying 0 Storage 90 stored in adipose tissue not much is stored in liver Associated with phospholipids in cell membranes 0 Vitamin E function Antioxidant Controls free radicals Protects phospholipids in cell membranes from damage Vitamin C is needed to regenerate Vitamin E after it is oxidized by a free radical 0 Vitamin E de ciencies Hemolytic anemia rare in humans Premature breakdown of red blood cells hemolysis Immune function impairment Neurological changes in spinal cord and peripheral nervous system 0 Vitamin E toxicity Relatively nontoxic At high doses can interfere with Vitamin K and affect blood clotting Vitamin K 0 Phylloquinones Vitamin K1 From plants green leafy vegetables broccoli peas and green beans Most biologically active 0 Main dietary form 0 Menaquinones Vitamin K2 From sh oils and meats Some synthesized by bacteria in colon 0 Vitamin K Functions Synthesis of blood clotting factors by liver Conversion of preprothrombin to prothrombin clotting factor Vitamin K must be reactivated once used Bone metabolism Converts vit Kdependent protein to Gla protein able to bind calcium 0 De ciencies very rare Newborns newborns are given Vit K injections within 6 hours after delivery longterm antibiotic use can interfere with Vit K synthesis by colon bacteria impaired fat malabsorption can cause de ciencies Megadose Vit A and Vit E can affect Vit K absorption 0 No toxicity No UL Chapter 13 Watersoluble Vitamins In general Storage in body tissues is minimal Risk of toxicity less than for fatsoluble vitamins Easily destroyed during cooking They form coenzymes true for all Bvitamins Cofactors are used by many enzymes in metabolic pathways Freed from food during digestion Grains Important source of B vitamins 0 Figure 131 Know where each vitamin participates 0 Flour forti cation Milling of grains causes loss of vitamins and minerals Thiamin Ribo avin Niacin Folate Iron added to our Thiamin Vitamin B1 De ciency Beriberi Coenzyme form is thiamin pyrophosphate TPP Used in metabolism of carbohvdrates and branchedchain amino acids Used in decarboxylation reactions Reactions that remove C02 from a compound functions as coenzyme in DNA svnthesis TPP is a coenzyme for transketolase Transketolase an enzyme that converts glucose to the 5carbon sugars which are components of DNA and RNA Ribo avin Vitamin B2 Yeow Component of avin adenine dinuceotide FAD and avin mononucleotide FMN Used in OxidationReduction reactions Used in many metabolic pathways Energy metabolism Fatty acid breakdown Used in formation of other compounds Niacin from the amino acid tryptophan Active vitamin B6 coenzyme from dietary source Synthesis of glutathione antioxidant n diet 25 from dairy Lightsensitive opaque containers recommended for milk De ciency Aribo a vinosis In ammation of throat mouth tongue Cracking at corners of mouth No upper limit no toxicity Niacin Vitamin B3 Exists in two forms Nicotinic acid niacin Nicotinamine Both forms can be used 0 Niacin in foods We can make some of our own niacin using tryptophan an essential amino acid as the starting material About half our niacin needs come from tryptophan conversion Ribo avin and Vitamin 36 are required to synthesize niacin Dietary Niacin in meat sh poultry Grains and forti ed enriched our and cereals Unlike other Bvitamins niacin is very heat stable and little is lost in cooking 0 Coenzyme forms NAD Nicotinamide adenine dinucleotide NADP Nicotinamide adenine dinucleotide phosphate These are each used in oxidationreduction types of reactions NAD and NADP are used in over 200 reactions Catabolism of proteins carbs amp fats Electron and hydrogen acceptor in glycolysis and citric acid cycle Alcohol metabolism Fatty acid synthesis 0 Niacin de ciency Pellagra Widespread damage in the body Rough skin rash on sunexposed skin Many other abnormalities such as dementia diarrhea and dermatitis 3 D5 Death if untreated Associated with nutrient poor cornbased diets Corn is low in tryptophan but has niacin Isolated cases today Alcoholism Malabsorption disorders Hartnup disease inability to convert tryptophan to niacin Niacin Equivalents NE Equal to mgs niacin from diet mgs niacin made from tryptophan in body 6 grams of protein intake containing tryptophan yields around 1 mg nracrn Pantothenic Acid Vitamin B5 Used to make coenzyme A We get Pantothenic Acid from a wide variety of food sources Pan z all Transported through the body bound to red blood cells Minimal storage stored as coenzyme A Coenzyme A is essential for formation of acetylCoA from the breakdown of the major nutrients l energy production Most acetylCoA feeds into the citric acid cycle D ATP production Some acetylCoA is used as a building block for making fatty acids bile acids cholesterol and steroid hormones Coenzyme A is also part of the acyl carrier protein which shuttles fatty acids through the pathway that increases fatty acid chain length Biotin Vitamin B7 Functions as a cofactor in carboxylation reactions Reactions that add C02 to a compound Some bacterial synthesis of biotin occurs in the large intestine Eggs are good source but avidin in raw egg whites inhibits absorption cooked eggs are ne Biotin is needed for Breakdown of amino acids for energy for four speci c amino acids creating starting material for gluconeogenesis a step in fatty acid synthesis Biotin also binds to proteins that stabilize DNA histones De ciency rare Can occur with regular ingestion of gt12 raw eggs per day Egg whites contain avidin a protein that binds biotin very strongly Vitamin B6 0 Food sources meat sh poultry whole grains nuts Toxicity Upper Limit Nerve damage o 36 coenzymes participate in 100 s of enzyme reactions PLP pyridoxal phosphate is the Vitamin B6 cofactor coenzyme for gt 100 reactions most involve nitrogen containing compounds amino groups 0 Amino acid metabolism Transamination to make nonessential amino acids Deamination use of amino acids as energy source Release of glucose from glycogen for maintenance of stable glucose concentrations Heme synthesis Neurotransmitter synthesis 0 Synthesis of niacin from tryptophan Support of immune function gene expression regulation anticancer Folate B9 Food sources foliage Leafy greens legumes oranges forti ed grains Folate in food usually has multiple glutamates Folic acid found in supplements and forti ed our contains only one glutamate In the intestine folate conjugases remove all but one glutamic acid from food folate to produce folic acid Onlv folic acid with one glutamic acid can be absorbed Some folate is stored in the liver rest released into the blood and delivered to the body Trapped in individual cells through conversion to a polyglutamate Excess folic acid is metabolized and excreted in urine and bile Food prep note Folate is very sensitive to heat oxidation and UV Upper Limit is set Higher levels may mask a Vitamin B12 de ciency De ciency 20 of women of childbearing age consume inadequate folic acid 5080 bioavailability absorption of folate from food Synthetic folate as folic acid with one glutamate is 100 bioavailable Dietary Folate Equivalents accounts for differences in absorption ef ciency Folic acid is more bioavailable than folate from foods Women capable of becoming pregnant need 400 mg of folic acid from forti ed foods and supplements in addition to folate obtained from diet 0 Folate function DNA synthesis Folate coenzymes are used in the synthesis and maintenance of new cells or rapidly growing cells tetrahydrofolic acid THFA lmajor coenzyme form used in reactions that transfer single carbons required for DNA synthesis making of purine and pyrimidine bases CGAT 0 Folate and 312 are closely linked 0 A Vitamin 312 coenzyme is needed to recycle THFA o Folate or 312 de ciencies Megaloblastic or macrocytic anemia Red blood cells can39t divide due to impaired DNA synthesis GI cells and immune cells also affected due to their rapid turnover and need to produce new DNA Neural tube defects spina bi da Maternal folate de ciency during the rst 2128 days after conception Serious consequences of 312 de ciency will occur before a woman would know she is pregnant Spina bi da spinal cord bulge through the back Vitamin B12 0 Plants cannot make B12 Made by bacteria We get 812 from animal products or forti ed foods 0 De ciency rare in meateaters Vegans and vegetarians need to supplement pregnant or nursing vegans especially 0 Meateaters generally have 23 years of storage in the liver 0 Complex absorption process HCI and pepsin in gastric juice release 812 from food in stomach Rprotein secreted in saliva binds to 812 as it passes through the stomach and carries it to the small intestine where proteases release B12 again R proteins protect 312 from damage by stomach acid Intrinsic factor a glycoprotein from parietal cells in stomach binds 812 when it is released by the Rprotein Intrinsic factor carries 812 to the ileum where 312 is absorbed Transcobalamin ll carries 812 in blood to liver BlZ stored in liver Bile recycling little loss in urine 0 Functions Formation of the amino acid methionine and of SAM a methyl donor important for DNA and RNA regulation B12 needed for normal folate function In absence of 312 THFA is trapped in methylbound form Needed with folate for DNA synthesis De ciency Pernicious anemia Choline Component of phospholipds needed for cell membranes Needed for synthesis of myelin protective sheath around nerves Choline needs high during infancy pregnancy nervous system growth We can make our own choline but not enough Vitamin C ascorbic acid Most animals can make their own Vitamin C We cannot Food sources citrus fruits peppers green vegetables best Least stabe vitamin Easily lost in storage processing cooking Smokers need more true for all antioxidants 0 Vitamin C roles 0 Oxidationreduction agent 0 Antioxidant Important role in collagen svnthesis Burn victims need high levels of vit C to allow collagen repair Used in synthesis of neurotransmitters and some hormones Immune function Vit C in meals assists Iron absorption 0 Vitamin C de ciency Scurvy Prevents the normal synthesis of collagen Widespread damage to connective tissues in the body Pinpoint hemorrhaging Impaired wound healing Chapter 14 Major minerals o 7 major minerals Na K Cl Ca P Mg 5 gt100 mg required day Trace minerals require less than 100 mgday 1 mineral in mass in the body Calcium Phosphorus is 2 0 General info Animal sources of minerals are usually more available than plant sources bioavailability Agricultural practices and food processing can affect the amount of minerals in foods Physiological need for a mineral often determines its absorption ef ciency Minerals of similar molecular weights and valence charges can compete for absorption affecting each other s uptake Individual mineral supplements can create a serious imbalance Components of food can in uence mineral absorption Phytic acid in wheat grain ber binds strongly to some minerals yeast breads are better than unleavened for mineral bioavailabilty enzymes in the yeast improve the mineral bioavailability Oxalic acid in leafy green plants reduces bioavailability Polyphenols in tea chocolate wine can lower bioavailability of minerals Vitamins can enhance bioavailability of some minerals Vitamin C enhances iron absorption Vitamin D enhances calcium phosphorus and magnesium absorption Gastric acidity HCI makes minerals more bioavailable by dissolving them and converting to a form more easily absorbed 0 Mineral Transport Many minerals have speci c binding proteins to carry them in the blood and even in cells while others travel freely Trace minerals are often very reactive and toxic in their free form and so usually have speci c carrier proteins 0 Mineral Functions Cofactors to assist enzymes Mg Se Cu Components of body compounds Fe in heme Transmission of nerve impulses and cell signals Na Ca K Water balance Na K Ca P Body growth Ca P 0 Mineral de ciencies Calcium 23 of people do not meet requirements K Mg also fall short of DRI recommendations Trace minerals Fe Zn I most likely to be de cient 0 Mineral Toxicities Excess can be toxic Particularly true of trace minerals iron zinc Sodium Na 0 Almost all the Na in our diet comes from salt NaCl Only about 1015 of the sodium in our diet is added as salt during home cooking and at the table 7580 from food processing and restaurants Salt or Nacontaining food additives 10 of our intake is of sodium that naturally occurs in foods Na is main solute in extracellular uids Functions helps absorption of glucose and some amino acids in SI Muscle and nerve function Water balance Main issue with Na is the association with hypertension heart disease and stroke AMAWHO goal of reducing sodium by 50 to reduce hypertension by 20 Need to cut salt in diet Na over 2gday can cause calcium loss in urine Kidney stones Potassium K 0 Need to increase potassium intake Plantbased foods are rich sources Fresh fruits vegetables milk whole grains dried beans and meat Unprocessed foods are best sources Function K is the major cation INSIDE the cell Similar functions to Na uid balance nerve impulses contracting muscle Potassium blunts effects of high Na intake De ciency Low blood potassium hypokalemia is life threatening Diuretics Eating disorders Alcoholics High blood potassium hyperkalemia is also life threatening Only an issue with kidneys that do not function well Chloride Cl Almost all comes from table salt NaCI Functions Main anion of the extracellular uid CI39 With Na maintains extracellular uid volume aids in transmission of nerve impulses Component of HCI stomach acid De ciencies with long bouts of vomiting loss of HCI weakness lethargy anorexia Phosphorus P Not a major nutrient concern Active Vitamin D enhances absorption in the small intestine Important roles in bone mineralization enzyme activity phosphorylation present in ATP phospholipids DNA and RNA 80 of the phosphorus in body in bones and teeth as calcium phosphate Remainder in cells and outside cells as PO4239 Main anion inside cells Bioavailability in grains and legumes is poor phosphorous is in undigestible phytate form Yeast can break down the phytates so yeast breads have enhanced P bioavailability Magnesium Mg Found in green leafy vegetables present in Chlorophyll plants are the richest source 45 of intake tap water if hard 0 Function Vitamin D facilitates Mg absorption Half stored in bones rest in other tissues Mg levels largely regulated by the kidneys Stabilizes ATP binds to phosphate groups Functions in over 300 magnesiumdependent enzyme reactions Mg needed for ATP DNA and RNA synthesis De ciency Irregular heartbeat weakness muscle spasm disorientation nausea seizures impaired nerve function Affects PTH vitamin D and calcium Risk of osteoporosis Sulfur S Most of sulfur in body found as components of the amino acids methionine and cysteine Also in other organic compounds like thiamin biotin and even insulin There is no Al RDA or UL for Sulfur No de ciency or toxicity symptoms 0 Protein intake supplies suf cient sulfur for our bodies Calcium Ca Sources Dairy foods made with dairy leafy greens forti ed juices and cereals tofu Commonly de cient in women and girls Calcium bioavailability varies greatly Oxalic acid in greens can bind much of the calcium Forti ed orange juice acid in juice helps absorption Bioa vaiabiity is an important consideration for vegans and nondairy eaters 50 from dairy products Different forms of Ca in supplements have different absorption abilities 99 of Calcium is stored in the bones and teeth Amount absorbed depends upon body needs may be as high as 75 pregnancy infancy or less than 25 Absorption most ef cient in upper small intestine where pH is still low enough to keep Ca2 in solution Blood calcium levels are regulated tightly Active vitamin D promotes and regulates Ca absorption see vitamin D section and gures for review Concentration of blood and cell calcium controlled by PTH calcitonin vitamin D and osteoclast activity Hyperparathyroidism can cause ongoing elevated Ca Calcium and bone metabolism Bone remodeling ongoing process of repair Osteoblast builds bone Osteoclast dissolves bone bone resorption Physical activity weight bearing activities and estrogen stimulate osteoblasts Always have balance of osteoblastosteoclast activity to repair bone Osteoporosis Prevention Bone building nutrients Active lifestyle with weightbearing activities Not smoking Drug therapy Estrogen and genetic factors are involved Beyond 30 years of age we start to lose bone mass Beyond 75 years of age hip fractures increase Estrogen up to 20 loss of bone in the rst 57 years after menopause DASH Diet Dietary Approaches to Stop Hypertension Lots of Fruits and vegetables Low fat dairy Low saturated fat total fat amp cholesterol Rich in magnesium potassium calcium protein amp ber This eating plan signi cantly lowers blood pressure as effective as some common blood pressure drugs
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