NTR108Exam2Guide.pdf NTR 108LEC
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This 9 page Study Guide was uploaded by Stephen Richmond on Monday October 26, 2015. The Study Guide belongs to NTR 108LEC at a university taught by Chabot, M A in Fall 2015. Since its upload, it has received 20 views.
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Date Created: 10/26/15
Module V Protein 1 Structure Amino Acid NH2 amine Central hydrocarbon CH with COOH Acid R Group R Group determines Amino Acids AA s StructureFunction AA Sequence dependent gt Each protein has Unique AA Seq there are In nite of Sequences Peptide Bonds Hold AA s together amp MUST be broken during digestion for absorption Abs DNA gt transcription gt RNA gt translation gt protein Ex Insulin or Sickle cell anemia W Malformation of Red Blood Cells RBCs Protein is an Essential Nutrient NTR Essential Amino Acid EAA s 9 EAA s Cannot synthesis win body Dietary Source Non Essential Amino Acids NEAA s 11 NEAA s Body Synth from other substances in diet Both EAA amp NEAA are Nitrogen Energy Sources 2 Function of Protein Structural MusclesSkinHair Growth Infants require high Protein Maintainrepair tissue Energy 4 kcalg Secondary Role energy from FatCHO s or atrophy would occur Regulation of Metabolism Protein derived Hormone production Insulin 51 AA sCCKglucagonsecretin Blood Protein Regulate Fluid Balance edemagt Swelling of tissue W uid from blood system Maintain pH Blood Clotting Fibrin Oxygen delivery Hemoglobin Hb Protein Transport Lipoprotein amp Albumin Enzyme Control Chemical Reactions DigestionAbsorptionMetabolism Immune Antibodies Ab 3 Protein Digestion Denaturation Protein loses function amp peptide bond is exposed for digestion Structural Change Polypeptides gt individual AA s digestion gt individual AA s used for tissue growthrepair Mechanism Physical Digestion Mouth mix food gt Chemical Digestion Stomach W HCl denatures 3D protein structure HCl pepsin break down protein gt Pancreatic digestive Enzymes secreted to Small Intestine SI polypeptide protein gt small peptide gt Intestinal enzymes break small peptides gt Dipeptides individual AA s lt Can be readily Absorbed SI Protein Absorption Occurs SI via enterointestinecytecell With 2ndary Active Transport Absorbed W Na similar to glc transporters are R group dependent transporters release AA s capillary gt Hepaticliver portal vein gt Liver Competitive Inhibition Excess intake of speci c AA can block Absorption of similar AA s Liver Regulator lst pick of AA s regulates levels of AA s in blood 4 AA Metabolism Transamination transfer amineNH2 from an AA to skeletal Carbon forming neWdifferent AA This is how NEAA s are synthesized Vit B6 Dependent Wout it all AA s are Essential Deamination remove amineNH2 from AA gtUses Excrete NH2Energy ProductionGluconeogenesis Vit B6 Dependent Nitrogen Excretion Kidney Liver Excess Nitrogen lost in Feces Insensible Loss Hair SkinN ails is Protein Form Excess NitrogenNH2 gtUrea synth Liver gt Kidney gt Urinary Excretion Can Live wout Kidneydialysis but not Liver NH2 gtNH3 ammonia Negative brain effect 5Pr0tein Requirement Balanced Input Output Intake better utilized w non excessive intake excess gt Energy Quality affected by digestibility determined by the amount EAA s in Lowest proportion Complete Protein High Quality All BAA s optimal ratio Animal products Incomplete Protein MissingLow amount of l or more EAA s Legumes rice veggies grain Complementary Proteins Combination of 2 or more Incomplete proteins to yield High quality protein High Quality Egg Quinoa 9 EAA grain Very Good Quality MilkMeat Soy Maintenance 1g protein 1 kg body mass sedentaryactive N Pregnant N lO20gday Lactating N 1015 gday Growth Phases High Protein Req Exercise EnduranceCardio or StrengthWeights gt Athletes 118gKg Disease Injury 2gKg RDA Sedentary Healthy adultgt 08gKg daily Determined by Nitrogen Loss per Day req protein to replace Nitrogen losses Protein quality Population variance 6 Vegetmnism Must Eat Complementary Proteins for complete EAA pro le DahlRicebeansetc Vegan No animal products many reasons for this lifestyleenvironmentalethicalhealthreligious lactoVegetarian Avoid Milk eggs Eat dairy products Lacto ovoVegetarian eats Milk Egg PescoVegetarian Eat Seafood PseudoVegetarian restrict Red Meat eats poultry Pros Low SatFatCholesterol High Fiber High VitaminAntioxidantRich in Low Energy density food Cons Low Iron cerealLow Ca2kale soy milkOJLow proteinEnergy densityPreg womenchildren Vegans B12 in supplemental form onlyyeast Meat soy milkcereal 7 Protein De ciency Kwashiorkor Protein malnutrition Minimal amount of calories Stunted growthmental retardation Impaired Immune SystemAntibodiesprotein dx Edema Lack albumin to retain H20 in blood gt pools elsewhere Intestinal malabsorption Lack digestive enzymes enterocytes amp won t make lipoproteinsfat transport Marasmus Protein Energy Malnutrition Massive Starvation emaciated appearance w depressed Immune system and growth Protein amp AA Supplements Useful to increase Muscle size Serineproline can be toxic Enhancing Muscle Gain Adequate Energy Intake Adequate Protein Intake Resistance Training At Risk for Supplement induced Harm Childbearing Women Adolescent Persons w Kidney disease Vit B6 H2O Soluble heatlight Sensitive Many forms Excessive intake gt numbness Function AA Metabolism transamination deamination Carb Metabolism Immune Function heme Synthesisrole in RBC production de ciency gt Anemia De ciency SignsSymptoms Anemiaconvulsionsdepressionconfusion Good Dietary Sources Per Serving Animal fleshnutsbeans Per Calorie Potatoesgreen veggiespurple fruitsbananas Supplements Used to treat PMS Carpal tunnel Syndrome Excess gt Nerve DamageSkin Lesions Module VI Energy Metabolism A Metabolism Glucose Anabolism building tissue amp Store glycogen Constructive build bodily compounds Catabolism Burning fat Destructive breakdown bodily compound for EnergyExcretion Metabolic pathway Glchexosefrom bloodglycogenLiverMuscle gtGlycolysisglc gt Energy Anaerobic Wout 0xygen gt ATP Formed in cytosol gt Lactate Lactic Acid gt Fatigue Aerobic W0xygen Pyruvate gt Mitochondria gt TCA cycle gt ATP C02 evolved 4kcalg Amino Acids from BloodIntracellular protein gt Excrete waste as urea synthesized in Liver Anaerobic cytosol gt similar to glc Aerobic Mitochondria gt Almost all converted to Energy 4kcalg Fatty Acid from Bloodcellular triglycerides Can Burn Fat When Oxygen available Wout Glc Ketogenesis gt Some ATP WGlc TCA CycleC02 EvolvedLots of ATP 9kcalg Alcohol Ethanol 6 US Caloric Intake gt Some ATP Most stored as Abdominal Fat 7kcaUg gt End Product Fatty AcidsATP C02 AcetaldehydeToxin B Vitamins Involved in Energy Metabolism B Vitamin Energy MetabNerve Functi0n Direct or Indirect use to convert Metabolic Substances to Chemical Intermediates Vitamins used as CoEnzymesActivate Enzyme gt Gen ATP gt Energy Thiamine H20 Soluble B1 rst discovered gt Function CoEnzyme for Energy Metabolism De ciency Beriberi m EdemaHeart Failure 0R y Nerve Function WeaknessParalysis De ciencygt DementiaAmnesia Due to Excess Alcohol Consumption Risk For Thiamine Deficiency Supplements can treat this Alcoholics Lost Liver Limited Absorption amp Poor Diet Removal of grain germ gt Dec Thiamine MalAbsorption AIDS amp Intestinal disorders Dietary Sources Whole Grain WGermEnriched GrainLeafy GreensLegumesPork Special Notes Nontoxic H20 SolLost in H20 gt Urine Excretion Larger Intake W Exercise Ribo avin H20 Soluble B2 gt Energy Metab SourceszMilk Leafy Greens Whole grain Risk Alcoholic Liver Disease Diabetes Special Notes Ribo avin is Light Sensitive De ciencygt Magenta TongueCracked corners of mouth Niacin H20 Soluble B3 ATP gt Energy amp Formation of Fatty Acids De ciencygt Pellagra DiarrheaDermatitisDementiaDeath0ccurs Poor Urban AreasAfricaAsia Risk Alcoholics amp Low Protein Intake Synth from EAA Tryptophan Sources Whole GrainEnriched Flour Protein W Tryptophan ChickenTurkey Special Notes B3Hypercholesterolemia Drug decrease LDL B3 Toxic High Doses Skin ushdiarrheaLiver damage Pantothenic AcidH20 Soluble B5 gt Energy Metab amp Fatty Acid SynthDe ciency Rare PanDietary Biotin H20 Soluble B7 gt Energy Metab De cientVery Rare Dietary Nuts MilkMeatEgg yolk Risk people Who consume large amt of Raw Egg Whites Avidin binds biotin gt Excretion C Minerals Involved in Energy Metabolism FeCuZnChromium Chromium Trace Mineral Rare De ciency Found in Whole GrainLiverSeafoodYeast Function Helps Insulin Glc Uptake Glc Tolerance Factor Needed to get Energy from Glc De ciency Symptomsgt Similar to Diabetes High Blood Glc Notes Present in Weight Loss Supplements Not Likely effective Iodine Trace Mineral Found in Iodized SaltSeafoodBaked Goods Function Developmental Role in Thyroid amp Energy Metabolism Regulation De ciency Goiter Swelling of Thyroid due to Trapped Iodine WeaknessWeight Gain amp RetardationPregnancy gt Fetus Affected Notes Toxic slightly above Requirement Goiter Risk Lacking Iodized SaltPoor Iodine Content in Area D Energy Intake Hunger Physiological Drive to eat due to absence of food Appetite Psychological drive to eat due to SightSmellThought of Food Satiety Both Drives are satis ed No Desire to Eat Hypothalamus Cell group at Brain Base Regulatory Function Including Hunger Energy balance EnergyIntakeOutput Balance ImbalanceWeight Inc Negative BalanceWeight Dec Energy Equivalence 1 lb Body Fat gt 3500kcal 10 Extra kcalday gt 1 lb per year Energy Expenditure Components of Energy Expenditure Basal Metabolic RateBMR 6075 calorie Fasting Rested Energy ExpenditureREE 12001400 cal Burned Involuntarily Factors Individual VarianceGender8 10 kcalkgh SE 09 Lean Body Mass Corrects Difference Age BMR Max 20 s amp Decline 5 per decade after Maturation Decline in LBM Height Taller Associated W Higher BMR Nutrition StarvationDieting Lower BMRXlt1200 kcal Fever Increase BMR PregnancyLactating Increase BMR Environment Tempscoldhot Inc BMR Physical Activity 153 5 Dependent on ActivityDurationWeightTrainingAfter Burn Thermic Effect of F00dTEF AbsorbingDigest Food 5lO lOOkcalDay Fat is calorie Dense amp Doesn t use calories during Absorption TEF Lower for High Fat food Heat Production Minor E Consequences of Energy Imbalance ObesityDieting at any given time 8 25 950 Cardiovascular DiseaseCVD High TriglyceridesHigh LDL Blood Pressure HypertensionDiabetes II 90CasesCancerBreastUterineProstateOsteoarthritis Inc Surgical RiskbleedinginfectionFatty Liver Disease Sleep Apnea Diagnosis of Obesity Desirable Body WeightIdeal Body Weight Estimate Body Fat Use Weight to Height Chart Metropolitan Life Insurance Tables BMI WeightKg Heightm2 Related to Obesity Risk Under Xlt185 Healthy 185249 Overweight 25299 Obese ISO399 Morbidly Xgt40 Limitations of BMINot for all agesBody Composition not consideredDoes not look at Location of fat Body Fat Distribution AndroidAppleVisceral Fat AbdomenCommon in MenInc CVD Risk See W Beer BellyNonactive GynecoidPearHipFemoral Fat SubcutaneousCommon in Women Less Health Risk Hard to lose Postmenopausal women shift body shapegt Inc CVD Risk Direct Measures of Fat lSkinfold measurements based on of Folds given site Optimal sites gender speci c Use multiple sites Primarily Subcutaneous Measurements 2 Underwater Weighing More accurate Higher muscle gt Higher Submerged weight Higher Fat gt Less weight Submerged in HZO Limited need facility amp Can t use w all people 3 BOD POD Air displacement Can t use w Claustrophobics 4 Bioelectric Impedance Fat Impedes Electric Flow Error Rate 34 Limits Measure Total Body Water amp People Must be Hydrated 5DualEnergy Xray AbsorptiometryDXA Accurate Xray Tissue differentiation Limits High Cost and takes time for test F CausesTheories of Obesity 1 Energy ImbalanceMetabolic Profile Differences 2 Genetic ImbalanceLeptin Defectgt Secreted Adipocyte Hormone that Decreases Appetite Accounts for 70 propensity of Weight Gain Twins have Similar weight patterns Somatotype is Heritable Ecto Lean Meso Muscular Endo morph 3 Large 3 Metabolic Theories a Setpoint Programmed weight w Body Fat Body adjusts Food intakeBMR b EnzymeLipoprotein Lipase LPL increases Cellular uptake of TGgt LPL more active with Starved Adipocytesgt Therefore Obese people have more LPL in adipose than non obese c Fat CelladipocyteAmount of fat per adipocyte Childhood gluttony gt Inc Adipocytes Don t Make new fat cells Maturation Obese people who lose weight dec Size of cell 4 Environmental In uences Lack of Exercise Screen timePortion sizeAlcoholFast Food Infrastructure City layout promote motorized commutes Marketing Commercialised Unhealthy Choices Schedules Unhealthy Lunches Inactivity Food Cost amp Food Desserts no access to fresh produce Lack of sleep gt Hormonal Change gt Inc Appetite Technology Enables less active Lifestyle G Treatment of Obesity 0 Prevention 1 Caloric Restriction Ideal Reducing Diet Doesn39t EXist 2 Weight Loss Programs Lifelong Lifestyle ChangesModerationgt Good Long term Outcome Exercise6090min moderate activityday Energy De cit Cut 500kcalday to lose 1 lbweekDon t go below lZOOkcalday Dec BMR Eat High Dietary Fiber amp Complex Carbs and Have large variety of Healthy Foods Fat 1030 Total Calories Protein RDA 5060gd Consistent Meal times Selfmonitoring Weekly Weighing amp FoodActivity Log Limit screen time and Meals out 3 Weight Loss Programs Poor Long term outcome Very Low Energy Diets Xlt lOOOkcalday 90 Failure RateLose Lean Body MassKetogenesisHeart Failure CHO restrictionAtkins Formulas Rigid Diet exclude Whole Food groups No Activity amp No Maintenance Phase 4 Weight Loss Medication SibutramineMeridia FDA Removed OrlistatXenicalBlock Fat Digesting Enzymes amp Limits Fat DigestionAbsorption Mechanism Fat Excreted Large Intestine Diarrhea Malabsorption of Fat Soluble Vits ADEK Qnexa Appetite Suppressant Effects serotonin lvl Antiseizureappetite med Birth Defects Belviq Appetite Suppressant 5 Bariatric Surgery Gastric Bypass Dec Stomach sizeegggtMalNutrition Lack Sphincter Rapid food Movt Sleeve Gastrectomy Vertical cut No Change in Length Lap Band Surgery AdjustableReversible Band Top of Stomachgt Feel Fuller Qualifying Criteria BMIgt4O OR BMI354O W Obesity related health concern OR Obese for 5years W weight loss attempt Pros Dramatic weight Loss lOOlbs in 8 month to year Cons Inc Surgical Risk Nutrition De cienciesBl2 Cost Followup surgery Special Diet 6 Weight Cycling Yo Yo Dieting More weight gain after metabolic changes from diet 7 Behavior Modi cations Use of Empirically demonstrated techniques to improve behavior Speci c Measurable Attainable Relevant Timebased SMART Goals Positive ReinforcementPunishmentAntecedent Removal Remove stimuli causing overeating Cognitive Therapy Learn to substitute accurate ideas for biased thoughts Food and Activity Logs Module VII Nutrition and Cancer A Background 1 Incidencebreastprostate colon 2nd Leading cause of Death in USHigher incidence in elderly 25 US people develop Cancer in lifetime 50 of cases are dietary related Epidemiology Study of populations Cancer Rates IncidenceMorbidity differencesEnvironmental In uences 2 Terminology Cancer cells Multiply uncontrollably and disrupt normal function Neoplasm New Cell Growth Benign or Cancerous Tumor Rapid andor uncontrolled increase in cell Benign Neoplasm No Widespread issues only localized at place of growthcell adhesion noninvasive Malignant Neoplasm CancerousResiste Treatment Harmful cells invade and do not adhere together Treatment Surgical RemovalRadiation Chemotherapy to decrease size Cell Growth Initiator Promoter cause uncontrollable growth gt Metastasis Movt to another area B Carcinogenesis 1 Carcinogen Cancer causing Substance Initiator that Damages DNA Causes RadiationsunXray amp Carcinogenic chemicals air pollutantspesticidesplants food and Microbial toxins 2 Promoter Increase Cell Division does NOT cause cancer AlcoholOral cancer High Estrogen Levels Obesity Q on oral estrogen Dietary Fat Promoter not Carcinogen Directly associated w Colon Cancer Mechanism Body secretes more estrogen gt Favorable environment for cancer growth OR Promoting the secretion of Bile Acids into Intestine where Microbes may convert them to carcinogens in the colon 3 AntiCarcinogenic OR Antipromoter Agents that protect against carcinogen or promoter a Decrease risk of tumor formation b Dietary Fiber AntipromoterAnticarcinogen Inverse relation w Cancer Low Fiber gt High Cancer Anticarcinogenic Quality Hastens Bile Acid Secretion ber holds onto Bile and Inc Movt through GIT Decrease Colonic Cancer Risk High Fiber Decrease transit time of Food in GITcolon gt Dec eXposure c EnergyCalories Reduce calories by 30 reduces Tumor Growth and Increases Lifespan d Antioxidants Vit ACE BetacarotenePhytochem precursor to Vit A SeleniumMineral Decrease OXidative Damage to DNA Regional or Widespread Interactions Cruciferous Vegetables Phytochemical containinggt Antioxidant Effectgt Cancer Protection Dietary Recommendations for Decreasing Cancer Risk 1 High Fiber Diet All types emphasised from Whole food sources 2 High FruitVegetable Intake Antioxidant rich DNA Protection amp Vit E Colonic Protection Various PhytochemicalsHelps With Increase Fiber 3 Low Fat only 30 Total Calories 4 Moderate Alcohol Intake 82 drinks 9 1 drink 5 Calorie Reduction Obesity Associated W Excess Estrogenother hormones Less Caloriesgt Less Oxidative Damage Module VIII Antioxidant Nutrients A Oxidation Change in structure of a molecule DNA proteinCell Mem LDL Due to Free Radicals Highly reactive molecules With Unpaired Electron LDL Plaque Formation Endogenous Produced Win the body Aerobic MetabolismDetox from Drugs Immune System response Exogenous SmokingAir PollutionAlcohol amp Detoxi cation B Antioxidants donate An Electron to Free Radicals Make Free Radicals Less Harmful Nutrients Vit CECarotenoids Food Source Nutrients Destroyed to Relieve Oxidative Damage Enzymes Need CofactorsSeleniumCuZn Work Against Oxidative Damage Phytochemicals Vit C Ascorbic Acid Immune FunctionLiver DetoxCollagen Formation for SkinVessels Inc Fe Abs H20 Sol Protects watery Areas of Bodygt Lung Antioxidant De ciency ScurvyFragile VesselsDec GrOWthAnemiaIncreased Infection Rate Risk SmokersPhysically Stressed PeopleAlcoholics Found in CitrusTomatoDark Leafy GreensPotato LOW Concentration Heat and Air Destruction of Vit C Vit E Fat Soluble Antioxidant for body lipidsgt Cell Membranes De ciency Anemia amp Neuromuscular Disease Risk People With NO Fat StorageLOW Fat DietFat MalAbsLarge intake of PUFA Smokers Sources Plant OilsEnriched eggsWhole GrainNuts amp Seeds Notes Toxicity Rare But Increased due to Supplements Interacts W Vit C And Selenium Vit A amp BetaCarotene BetaCarotene non Vitamin Precursor of Vit A 300 types of carotenoids highly colored Function Vit A Conversion amp Antioxidant for Lipoproteins LDL Vit A Fat Soluble Vision Func Cell DifferentiationPrenatalBone healthImmune RoleAntiOxidant De ciency Night BlindnessBlindnessCVDCancer Risk InfantsChildren in developing countriesLOW Fat DietFat MalAbsAIDSCystic Fibrosis Sources VitA Dairy ProductsEggsLiver Carotenoids Dark Green VeggieOrange FruitVeggie Notes Needs Vary W Body Weight and fat Composition Toxicitygt Birth Defects Used in Acne Meds AntiWrinkle drug Chemotherapy Agent Selenium Trace Mineral Cofactor for Antioxidant EnzymesAction Dependant on enzyme Concentration Excess Cofactors are Wasted or harmful De ciencyDegenerative Heart Disease Cancer Risk People that eat from Soil LOW in Selenium China Dietary Source Whole grains Toxicity very close to RDA Phytochemicals amp Zoochemicals ColorFlavorOdor protection to Plants Non Essential Dietary Source Antioxidant Properties TanninsTea Carotenoids Dark Green Orange Veggies Garlic Odor Antioxidant Nutrients and Chronic Diseases 1 Heart Disease Oxidative Damage to LDL and Cholesterol 2 Agerelated CataractCognitive FunctionArthritis 3 Diabetes 4 Cancer BreastLungColonProstate Module IX Nutrients and Bone Metabolism A Bone and Skeleton Bone is part of the Skeletal System it is a living tissue that constantly undergoes changes Bone is Composed of MineralsProteincollagen Matrix Skeleton Part of Body left after removal of Soft Tissues Consist of BoneCartilageLigaments Functions Calcium amp Phosphate Storage SupportProtectionMovt Muscle attachmentHematopoiesis Composition 99 Bodily Calcium Bone Calcium Phosphate and Calcium Carbonate With Protein Bone Turnover Max Bone in Late Twenties Max is Genetically Controlled Formation Greater Childhood Adults 35 to 45 Yrs Formation Breakdown39 Lack of Vit D and Calcium Decreases Bone Adults 45 Yrs Breakdown gt Formation Postmenopausal Breakdown gtgt Formation can be aided with Hormone Replacement therapy B Calcium Phosphorus Fluoride Vit A Vit D Ca Major Mineral Nutrient Bone StructureNerve transmissionMusc Contractionblood Clotblood pressure De ciency TetanyOsteoporosisHypertension Risk PoorKidsPregnantElderlyLow Ca Intake Postmenopausal Women Dietary Sources DairyBeansBroccoliDried fruitTofuMolasses Forti ed FoodJuices Increased Needs GrowthlactationKidney or Liver FailureElderlyHigh Phosphate Diets Phosphorus Found as a Phosphate PO4 Neg 3 Charge Source Soda Component of DNARNAPhospholipidsATPBones De ciency WeaknessAppetite LossMuscle Pain Risk RARE Preterm InfantElderlyAlcoholicsPostmenopausal Women Notes Metabolism Inactive Vit D Synth from Subcutaneous Cholesterol gt KidneyLiver Activated gt Hormonal Effect Occurs when Blood Calcium Levels are too Low Toxicity 10X RDA Likely Over Supplementation gt Calci cation of Soft Tissue KidneyLivergt Bad FluorideF HZOsoluble Tap H20 only Retards Dental CariesCavities Young People Develop Fluorosis Speckled teeth from eating Large amounts of toothpaste w F Vit D FatSolubleHormonal Role amp Enhances Ca2 Abs in SI Limited Uptake from sun w Sunscreen Can be toxic gt calci cation of Soft Tissue De ciency Rickets Bow Legged Source Forti ed Milk Egg Yolk Fish Oil C Relationship Between Major Nutrients Inc B0neDec Bone Vit C gt needed for Collagen Synth Vit A gt Maintain OsteoblastsOsteoclasts Source of Low Blood Calcium High dietary PhosphorusLow Calcium Diet Resultsgt Osteoclastic Activity gt Increase Blood Calcium gt Activation of Vit D gt Inc Intestinal Absorption of Calcium Vit D Helps gt Dec Urinary Loss of Calcium Vit D Helps D Osteoporosis Hard and Brittle Bone Disease Due to Loss of bone mineral and protein Fractures are the problem caused by Falling Use Dexa Scan to measure Bone Density More Frequent in Women Genetically Lower Bone Density Risk Factors Age After 45 Yrs amp Postmenopausal Women Wout Hormone replacement Therapy GenderHormones Racial Caucasian Highest Risk Low Density Asian Intermediate Lowest Density African American Lowest Risk Highest Density Smoking Increases Risk Early Menopause Onset Alcohol Increase Ca Loss and Fall Risk gt Physical Activity Weight bearing exercise decreases riskIncrease Bone mass no matter age lt Decreases Fall Risk Increase Appetite Dec Risk amp maybe Inc Ca intake Low Calcium IntakeVit D in rst 30 Years of Life amp Underweight Persons Recommendations High Ca Intake when younggt Increase MaX Bone Density Avoid High Phosphorus Intake Sodas Ca Supplementation l gd Antacid Supp can Cause Iron De ciency or Kidney stones Heavy Metals Ca Supplements Abs At same Percent 3 03 5 Determined by amount of Ca not Weight Chelators make Calcium more H20 Soluble Synthetic CaCO3 good CaC12 bad CaGluconate good Low Ca CaCitrate Best Natural May be Contaminated with Heavy Metals Oyster ShellDolomiteBone meal
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