Becca Curry Katie Glynn Laura Hardy Megan Solloway

http://enabledkids.ca/?p=2286

 Introduction Dietary

Sources Absorption Excretion Major Functions Clinical Functions Questions

 In

honor of the upcoming break

GOT MILK?

http://www.geocaching.com/geocache/GC215PB_8-maids-a-milking-aka-8-redholsteins?guid=ba61e4fd-0b39-4c92-88e4-750d510eff76

o o o

Supplements, Dairy Products, Fruit, Vegetables, and Beans Roughly half comes from dairy sources Beans and vegetable sources have a higher absorption rate ~60% in comparison to dairy sources ~ 30% Fortified foods have roughly same absorption rate as dairy products o Calcium Citrate Malate
http://energy.healthfoodxdrinks.com/calcium-rich-foods-that-keep-your-bonesstrong/

 Calcium

Carbonate and Calcium Citrate

Carbonate should be taken with food Citrate does not need to be taken with food
Amount

of elemental calcium Symbols for Lab testing

At home: place supplement in a glass of lemon

juice, stir at intervals for 30 minutes. If not dissolved after 30 minutes suggested to find a different supplement

 Study

conducted by Angel R. et al. to analyze how differing calcium sources impacted postmenopausal mice
Dairy forms showed lower adipose fat for mice Supplement (calcium carbonate) form revealed

higher bone density

 During

times that the body needs more such as growth periods and pregnancy In a low pH environment Lactose Fat Intake Vitamin D levels Exercise
http://www.bcps.org/offices/lis/models/life/humanchart.ht m

 Deficient

in Vitamin D Insoluble fiber Oxalate and Phosphorus Alcohol consumption Caffeine Sodium

The amount we absorb depends on how much calcium we normally intake Digested mainly in small intestines and very little in large intestine Three general mechanisms of calcium absorption
Transcellular active

transport process Paracellular (passive) Some Calcium Absorption in Large Intestine

http://www.finerminds.com/health-fitness/foods-that-fight/attachment/calcium-food/

 Only in duodenum when the calcium intake is low Requires ATP The calcium crosses the intestinal brush border Calcium crosses plasma membrane via calcium

channels Ca ATPase mediates the extrusion of calcium and is located in the basolateral membrane.

 Occurs only in jejunum and ileum when calcium

intakes are moderate or high No ATP required Concentration gradient is set up between the calcium in the lumen and in the basolateral side of the enterocyte Ionized calcium diffuses through tight junctions between intestinal cells into the basolateral spaces around the enterocyte and enters into the blood. Responsible for most of calcium absorption because the calcium has a short amount of time for active transport in the duodenum

 Bacteria

releases calcium that is bound to fermentable fibers (ex: pectins) 4%- 10% of dietary calcium is absorbed by the colon each day

http://www.argosymedical.com/Digestive/

 Excess

calcium that cannot be stored is excreted in urine, feces and sweat

Urinary loss: incomplete reabsorption Fecal loss: endogenous sources (bile) not

reabsorbed by intestines
Diet

can directly effect excretion

 Hormones

regulate blood levels

Parathyroid Hormone Calcitriol Calcitonin

Estrogen

www.mayoclinic.com

 Phosphorus Increases reabsorption & uptake by bone Sulfur Sulfur-containing amino acids in protein Sulfur Sulfate Sulfate binds to Calcium Prevents both bone incorporation and kidney

reabsorption
Sodium Every extra 2 grams of dietary sodium increases

calcium excretion by 30-40 mg

http://ajcn.nutrition.org/content/88/4/1159.full.pdf

 High-Sulfate Sodium Coffee Tea Alcohol

Animal Protein

 Alkalogenic

diets

Fruits
Vegetables

 Bones

& teeth = 99% of bodys Ca stores

Most prevalent mineral in

bone
Bones = LIVING tissue Protein strengthened by

calcium and phosphorus deposits

Calcium + phosphorus = hardness Collagen = flexibility and strength

Osteoblasts = bone formers = produce bone collagen fibers o Collagen fibers are laid down o Osteoblasts extract calcium, phosphorus, and other nutrients from the bloodstream Ossification o Osteoblast supervise deposits of sharp, calcium phosphate crystals over top of the collagen layers o Crystals act as cement and give bone its white appearance
o

 Only

1% of calcium found outside the bone = critical!

Important for: Blood clotting Blood pressure stabilization Normal brain function Cell communication Muscle contraction Reproductive health and much more!

Low Blood Calcium Levels

High Blood Calcium Levels

Calcium circulating in the blood that carries an electrical charge Accounts for about of circulating calcium Particularly important in:

Cell function The coagulation cascade Muscle contraction

Neural impulse signals SR to release large amounts of Ca into the myofilaments Increase in Ca concentration causes shortening of myofilaments = muscle contraction Neural signal stops = SR calcium channel closes = muscle relaxes

 Slow

Twitch vs. Fast Twitch

Fast Twitch = more developed SR Faster Ca release upon neural signal Faster contraction upon neural signal = explosive movements

 Osteopenia

& Osteoporosis
Low bone density
Thin, brittle, porous

+1

http://www.health.harvard.edu/newsweek/Osteopenia_When_you_have_weak_bones.htm

 Osteopenia & Osteoporosis Peak bone mass density (BMD) around age 30 Calcium intake essential prior to/in this period Most common in elderly, postmenopausal women European, Asian, family history Smoking, alcohol, no weight-bearing exercise

 Deposits

may form as reaction to trauma Pain, stiffness Most often in shoulder- rotator cuff 30-50 years old, women Diagnose w X-ray Treatment
Rest, ice, medicine Surgical break-up or removal

 Dysregulation

of calcium metabolism in they body leads to elevated risk of vascular calcification Kidney failure can lead to excess excretion and low calcium levels
Interaction with high phosphorus levels can

causes hypocalcemia Inability to create vitamin D is also a factor Acute kidney failure can cause hypercalcemia
Excessive

calcium intake may lead to kidney stone

All about Calcium Supplements. Department of Health. Available at http://www.health.ny.gov/diseases/conditions/osteoporosis/calcium_supplements .htm Angel R., Berrigan D., Nunez N., Hursting S., Perkins S., Dietary Calcium Source Influences Body Composition, Glucose Metabolism and Hormone Levels in a Mouse Model of Postmenopausal Obesity. In Vivo. Available at http://iv.iiarjournals.org/content/23/4/527.full.pdf+html Bronner B. Calcium Absorption A Paradign for Mineral Absorption. American Society for Nutritional Services. 1998; 5: 917-920. Calcium. Office of Dietary Supplements: National Institute of Health. Available at http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/ Fleming K., Heimbach J. Consumption of Calcium in the U.S.: Food Sources and Intake Levels. TAS 2007. Available at http://jn.nutrition.org/content/124/8_Suppl/1426S.long Gropper SS, Smith JL. Advanced Nutrition and Human Metabolism, 6th ed. Belmont, CA: Wadsworth; 2012. Lanou AJ., Should Dairy be Recommended as Part of a Healthy Vegetarian Diet? Counterpoint. Am J Clin Nutr May 2009 vol. 89 no. 5 1638S-1642S. Peacock M. Calcium Matabolism in Health and Disease. CJASN. 2010; 5: 2330.

Guguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll of Nutr. 2013; 19: 119S-136S. Fenton TR, Eliasziw M, Lyon AW, et al. Meta-analysis of the quantity of calcium excretion associated with the net acid excretion of the modern diet under the acid-ash diet hypothesis. Am J Clin Nutr. 2008;88:1159 1166. Calcium Deposits and Tendinitis (Calcific Tendinitis). WebMD. 2011. Shanahan C., Crouthamel M., Kapustin A., Giachellia C. Arterial Calcification in Chronic Kidney Disease: Key Roles of Calcium and Phosphate. Calcium Research. Available at http://circes.ahajournals.org/content/109/6/697.short Morgan L. Calcium and Renal Failure. Live Strong. Available at http://www.livestrong.com/article/448188-calcium-renal-failure/