what is the word breakdown of osteoporosis?
osteo = bone
porosis = porous (weakening)
what is osteoporosis?
a systematic skeletal disease characterized by low bone density with micro-architectural deterioration of bone and fragile bone
what is osteoporosis often called?
silent disease
what type of disease is osteoporosis?
a metabolic disease because there is an imbalance in the metabolism of calcium
what type of nutrient is calcium?
micronutrient
how many Americans have low bone density?
53 million
is osteoporosis more common in men or women?
3x more common in women
why is osteoporosis more common in women?
because there is a drop in estrogen after menopause and because women tend to live longer and therefore there is a greater loss in bone mass
osteoporosis leads to how many fractures per year?
2 million
where are the most common fractures in those with osteoporosis?
wrist
hip
spine
what is an osteoblast?
cell that plays a role in the formation of bone
deposits calcium
what is an osteoclast?
cell that plays a role in the breakdown of bone
dissolute calcium (take out)
when someone has osteoporosis, how is the osteoblast/osteoclast activity affected?
decreased osteoblastic activity (formation)
or increased osteoclastic activity (resorption)
what is the risk of bone fracture for women and men?
women: 1/2 older than 50
men: 1/4 older than 50 (men have fewer fractures but 2x the mortality)
which fracture is the most serious?
hip
what are the causes of osteoporosis?
menopause (ovarectomy)
older than 50
genes (family history)
physical inactivity
low intake of vitamins b12 and K, potassium, magnesium
low calcium diet
extensive use of corticosteroids
small frame
white or asian
heavy drinking (limits deposit of calcium in bone → decrease in osteoblastic activity)
smoking
at what age do men and women have their peak bone mass?
both 30-40
how is osteoporosis diagnosed?
X-ray
bone mineral density test
what are lifestyle changes that can improve bone health?
increase intake of calcium (1000mg in men and 1300-1500 in women)
increase intake of vitamin D (calcium and phosphorus absorption
balanced food (protein, carbs, fats, minerals)
exercise
smoking cessation
less alcohol consumption
only take meds if needed (they can affect bone density)
excess calcium leads to what?
calcium binds to oxalic acid and there is stone formation
(we want calcium to bind to phosphorus to make bone)
what happens when there is to much protein? how about to little?
too much: interferes with calcium absorption
too little: no collagen
what are nutrients other than calcium that are vital for bone health?
vitamin D: absorption
protein: collagen
potassium
vitamin K
magnesium
phosphorus
what is the recommended daily intake of calcium for men and women?
men: 1000 mg
women: 1200-1500 mg
what are foods that are calcium rich but low fat?
kidney beans
non fat milk (calcium fortified)
cheese
leafy greens
yogurts
brocoli
orange juice
salmon
sardines
tofu
baken beans
how does normal milk differ from skim milk?
normal milk: more vitamin D and fat → fortified
skim milk: more vitamin C
what can interfere with calcium metabolism?
excessive fiber: limits intake of high calorie food
excessive sodium: increase urinary calcium excretion; removes calcium from bone/osteoclastic increase (recommended amount is 2,300 mg)
unbalance/high protein: increase urinary excretion of calcium
carbonated soda: contains phosphorous which eliminates calcium from the body (excessive phosphorus = osteoclastic increased_
what are calcium and phosphorus metabolism controled by?
calcitonin that is released from parathyroid gland
do we need more or less vitamin D as we age? how much?
more
younger than 50: 200 IU
51-70: 400 IU
over 70: 600 IU
what are foods containing high vitamin D?
fish oil, cod liver
herring
catfish
oysters raw
salmon
salt water fish
how does sunlight affect vitamin D?
sunlight activates the vitamin D that is from our food
what is a sufficient amount of sunlight per week?
10-15 mins 2-3 times a week
weight-bearing activity stimulates which bone cells?
osteoblastic
what are the two types of exercise that make bones stronger?
weight bearing exercise: makes us work against gravity while being upright
muscle-strengthening exercises: (resistance exercises) make us move our body
examples of high impact weight bearing exercise
dancing
aerobics
hiking
jogging
jumping
stairs
tennis
volleyball
examples of low impact weight bearing exercises
elliptical training
low impact aerobics
walking (on level surfaces)
which exercises are better for low bone density?
low impact
how does walking in a pool affect normal people compared to people at risk for fracture?
normal people: not a good way to build bone strength
people at risk for fracture: good way
recommended amount of weight bearing activity for children, adults, and older adults?
children/adolescents: 60 mins per day
adults: 150 mins per week
older adults: same as adults per ability
what are some examples of muscle strengthening activities?
weight machines
hand or ankle weights
elastic bands
moving against gravity
recommended time for strength training?
2-3 days per week
go to fatigue
1-3 sets of 8-10 reps
endurance: high frequency low weight
strengthening: low frequency high weight
what is the difference between endurance and strength training?w
what are the 5 simple prevention steps?
get daily recommended amounts of calcium and vitamin D
engage in regular weight bearing exercise
avoid smoking and excessive alcohol
talk to doc
have a bone density test and only take meds when needed
what are the bone health building blocks?
CDEFG S
C: calcium
D: vitamin D
E: exercise
f: fall prevention
G: gain weight
S: smoking cessation
what is the most important factor in preventing bone loss?
estrogen
oligomenorrhea
irregular menstral cycles
amenorrhea
cessation of regular menstrual flow