Osteoporosis

Dr. Ghosh Spring 2023 - Exam 2

Osteoporosis

a systematic skeletal disease distinguished by low bone density with micro-architectural deterioration of bone and fragile bone

Another name for osteoporosis

silent disease

Effects of osteoporosis

* inhibits ossification
* causes the spine to collapse
* fractures

Ossification

bone formation

How many Americans have low bone density?

43 million

How many Americans have osteoporosis?

10 million

Men account for 2+ million

Commonality of osteoporosis

3x more common in women than men (specifically athletes)

Why are women more prone to osteoporosis?

drop in estrogen after menopause and the higher life expectancy compared to men

Most common fractures

wrist, spine, and hip

Mineral associated with osteoporosis

calcium

Osteoblast

bone-forming cells

Osteoclast

bone resorption cells

Ratio of osteoblasts to osteoclasts

balanced (it is essential to remodel bone throughout life)

How many women are prone to bone fractures after age 50?

1/2 (50%)

How many men are prone to bone fractures after age 50?

1/4 (25%); suffer twice the 1 year mortality

Most serious fracture

Hip

Number of hip fractures that lead to hospitalization each year

300,000 annually

Number of people with a hip fracture and end up in a nursing home within a year

1 out of 5

Causes of osteoporosis

smoking, heavy drinking, menopause or ovary removal, age older than 50, family history, physical inactivity, low intake of vitamins, low-calcium diet, extensive use of corticosteroids, small frame, and white or asian individuals

Lifestyle changes to improve bone health and reduce fractures

* Calcium, Vitamin D, and Balance food intake
* exercise, smoking cessation, less alcohol, and medications

Guideline for sufficient calcium

1,000-1,300 mg/day with weight-bearing activities

Nutrients vital for bone health

calcium, vitamin D, protein, potassium, vitamin K, and magnesium

Calcium rich foods

cheese, leafy green vegetables, low fat milk, salmon, sardines, tofu, and yogurt

Where does most of our calcium come from?

milk and dairy products

Most common sources of calcium

milk, cereal, raw broccoli, orange juice, and baked beans

What can interfere with calcium metabolism?

excessive fiber, excessive sodium, unbalance high-protein diets, carbonated soda

What increases the urinary excretion of calcium?

unbalanced high-protein diets and high sodium

Vitamin D needs for:

(1) up to 50 years old

(2) 51-70 years old

(3) over 70 years old

1. 200 iu
2. 400 iu


1. 600 iu

Vitamin-D rich foods

fish oil, herring, catfish, raw oysters, salmon, and salt water fish

Where is most of our vitamin D obtained?

through the direct exposure of sun

What does the amount of vitamin D depend on?

time od day, season, latitude, and skin pigmentation

Recommended amount of time to sun exposure

10-15 minutes 2-3x week

Types of exercise that improve bone strength

weight-bearing exercise and muscle-strengthening exercise

Weight-bearing exercise

makes an individual work against gravity while being upright

i.e. brisk walking

Muscle-strengthening exercise

move our body

i.e. weights, resistance against gravity

Examples of high-impact weight-bearing exercises

dancing, aerobics, hiking, jogging/running, jumping, stair climbing, tennis, and volleyball

Examples of low-impact weight-bearing exercises

elliptical training machines, aerobics, walking on a treadmill, walking on level surfaces

Recommended amount of weight-bearing exercise for children/adolescents

60 min of moderate to vigorous every day w/ high impact

Recommended amount of weight-bearing exercise for adults

150 min of moderate or 75 min per week of vigorous

Recommended amount of weight-bearing exercise for older adults

same as adults but adapted as needed based on health

Examples of muscle-strengthening exercises

weight machines, hand/ankle weights, elastic exercise bands, moving against gravity

Recommendations for strength training

2-3 days/week

1-3 set x 8-12 exercises

hard enough to fatigue by 8-10 repetitions

Spine fractures effects

pain, stooped posture, loss of height, difficulty breathing, and decreased self-esteem

5 prevention steps

1. get the daily recommends amounts of calcium and vitamin D
2. engage in regular weight-bearing exercise
3. avoid smoking and alcohol
4. talk to a physician
5. bone density test and take medication when appropriate

Bone health building blocks

calcium, vitamin D, exercise, fall prevention, gain weight, and stop smoking

Risk factors for osteoporosis in women

loss of estrogen, history of oligomenorrhea and amenorrhea, and post-menopause

Oligomenorrhea

irregular menstrual cycles

Amenorrhea

cessation of regular menstrual flow

Hormone Replacement Therapy (HRT)

adding estrogen and progestin increases the risk for disease