Nutrition for Bone and Dental Health

 

• Nutrition and Bone

  • Macronutrient

    help develop and maintain bone

    → perkembangan dan menjaga

    • protein
    • karbo

  • Micronutrient

    essential for normal bone structure and function

    →membantu struktur berfungsi normal

    • vitamin
    • mineral

Nutrition for Bone Health

• Concept of energy balance

  • Energy balance

    Stable body weight→ Energy intake does not have a direct effect on bone

  • Positive energy balance

    Weight gain→ Osteoartritis (sendi kena)

  • Negative-energy balance

    Weight loss→ Osteoporosis

  

Macronutrient

• Protein and Bone

  • Komponen pembentukan tulang PBM (Peak Bone Mineral Density) pada usia 30 tahun→ Diet dan pengaturan makan 0,8-1 kg berat badan

  • Indeks protein→ indikator kesehatan tulang berbanding positif

  • Teori banyak protein banyak asam→ meninngkatkan kalsium pada urin→ BELUM terverifikasi

  • Meningkatkan absorbsi kalsium tapi juga meningkatkan asam bisa eksresi kalsium

  • Protein and calcium are important components of PBM, especially before puberty

  • A meta-analysis of studies concerned with protein intake and indicators of bone health found a slight positive effect on BMD,

    

    • The theory that higher protein intakes produce a higher acidic load, which increases calcium urinary excretion, has not been verified
    • Although dietary protein may increase acid load and thereby increase urinary calcium excretion, protein also may improve calcium absorption and increase growth factors, which also could improve bone health

• Calcium & Bone

  • Food sources are recommended first for supplying calcium needs
  • Calcium for poultry are better than plant based diet
  • AKG : 1000 – 1200 mg/day
  • Dipenuhi melalui makanan paling banyak sumber hewani (daging ayam, ikan, tahu, tempe)
  • bisa pake supplement tpi hrs dalam batas normal, upperlevel→ kadar maksima yang bisa diterima tubuh

  

• Phosphorus and Bone

  dipenuhi dari makanan, ada penilaian gizi selama 24 jam→ software

  ada juga yg 3 bulan terakhir dan brapa jumlah

  • The body’s reserve of phosphorus is found in the bone as hydroxyapatite.
  • Phosphate salts are available in practically all foods either naturally or because of processing.
  • In healthy adults, the urinary phosphorus excretion approximately equals intake.
  • AKG : 700 – 1200 mg/day

Micronutrient

• Vitamin D and Bone

  → kesehatan tulang, bantu transportasi kalsium ke saluran pencernaan

  → menjaga kadar serum kalsium dan fosfor

  → perlu paparan sinar matahari untuk diaktifkan

  • Vitamin D plays a pivotal role in calcium uptake and therefore bone homeostasis
  • The main function of vitamin D is to maintain serum calcium and phosphorus levels within a constant range,
  • Vitamin D is important in stimulating intestinal calcium transport.
  • Vitamin D also stimulates activity of osteoclasts in bone.

  

• Vitamin K and Bone

  • Vitamin K is an essential micronutrient for bone health. Its role in post-translational modification of several matrix proteins, including osteocalcin, is well established.
  • After bone resorption**,** osteocalcin is released and enters the blood. In this way, osteocalcin serves as a serum bone marker for predicting the risk of a fracture.

• Dietary Fiber, Isoflavone, & Caffein

  → serat: (bagian dari karbohidrat komplek)→ isi oxalate (bayam)→menghambat absorbsi mineral

  → kacang → isoflavone→ estrogen agonis dan antioksidan pada sel tulang→ menghambat bone resorption

  → kafein (kopi) → menganggu Bone Mineral Density

  • Excessive dietary fiber intake may interfere with calcium absorption
  • High-fiber foods that contain phytates or oxalates may lower calcium absorption
  • The isoflavones in soybeans function as estrogen agonists and antioxidants in bone cells.
  • They inhibit bone resorption in female animal models without ovaries, but not in young adult females with normal estrogen status
  • Excessive caffeine intake may have a deleterious effect on BMD

Nutrition for Dental Health

• Macronutrient & Dental Health

  • An insufficient supply of proteins can lead

    ****(i) atrophy of the lingual papillae,

    (ii) alteration in dentinogenesis,

    (iii) alteration in cementogenesis,

    (iv) altered development of the maxilla,

    (v) malocclusion,

    (vi) linear hypoplasia of the enamel

  • An insufficient supply of lipids can lead

    ****(i) inflammatory

    (ii) parotid swelling—hyposalivation,

    (iii) degeneration of glandular parenchyma,

    lemak jenuh→ di suhu ruang padat (gajih)

    lemak tak jenuh→ di suhu ruang cair (minyak)

    hindari lemak trans fat foods

  • An insufficient supply of carbohydrates can lead:

    ****(i) altered organogenesis,

    (ii) influence of the metabolism on the dental plaque,

    (iii) caries,

    (iv) periodontal disease

• Type of macronutrient

  tumpeng gizi seimbang

  1 sendok makan minyak: dianggap 1 porsi

  • Protein

    0.8 – 1 g protein/kg body weight

  • Fat

    20% to 35% kcal energy/day (dari total kebutuhan energi 1 hari)

  • Carbohydrate

    55% to 70% kcal energy/day

  

• Micronutrient & Dental Health

  A shortage of vitamins and minerals in the phase before conception influences the development of the future embryo, influencing dental organogenesis, the growth of the maxilla, and skull/facial development

  • Development of the Enamel

    • A lack of vitamins D and A and protein-energy malnutrition have been associated to hypoplasia of the enamel and atrophy of the salivary glands, conditions that determine a greater susceptibility to caries.
    • Some hypoplasia and pits on the surface of the enamel correlate to a lack of vitamin A; a lack of vitamin D is associated to the more diffused hypoplastic forms. The structural damage can testify to the period in which the lack of nutrition occurred

  • Caries

    • Sugar
    • Bacteria
    • Saliva
    • → diminlisir dengan serat dan komplek (gandum)
    • → kurangi karbo sederhana (gula)
    • Increase in the consumption of fibers: diminution of the absorption of sugars contained in other food.
    • Diets characterized little sugar have very low levels of caries.
    • Cheese has cariostatic properties.
    • Calcium, phosphorus and casein contained in cow milk inhibit caries.
    • Wholemeal foods have protective properties: the90ooooooooop0oy require more mastication, thus stimulating salivary secretion.
    • Peanuts, hard cheeses, and chewing gum are good gustative/mechanical stimulators of salivary secretion.
    • Black tea extract increases the concentration of fluorine in the plaque and reduces the cariogenicity of a diet rich in sugars.
    • Fluorine 🡪 Small amounts of fluoride help reduce tooth decay

  • Flourine

    • When fluoride, as sodium fluoride, is ingested with water, almost 100% is absorbed
    • When fluoride is consumed inmilk or baby formula 🡪absorption is decreased
    • A diet high in fat content may increase fluoride absorption due to a reduction inthe rate of gastric emptying

    

    tea, seafood, bone meal, spinach and gelatin, the least in citrus fruits, vegetables, eggs and milk