Nutrition Week 8 - Osteoporosis

Front 1

1.Osteoporosis is .....
2. characterized by ______ and _______
3. Results in ________

Back 1

1. Metabolic bone disease
2. Low bone mass + deterioration of bone tissue
3. increase in fragility fractures

Front 2

1. What is a fragility fracture?
2. Body parts most susceptible (3)

Back 2

1. results from minimal trauma (fall from standing) or no identifiable trauma

2. Hip + Spine + Wrist

Front 3

Why is Osteoporosis considered a Paediatric Disease with Geriatric Consequences?

Can disease strike at any age? + Especially common for _________

Back 3

- peak one mass reached in adolescence and if not built then, chances of osteo increase in older age
- early prevention necessary

Yes + White/Asian women over 50

Front 4

Reduced quality of life for people with osteo why?

Back 4

- disfigurement
- low self esteem
- reduced/loss of mobility
- decreased independence

Front 5

Osteoporosis Symptoms

Back 5

- pain
- reduced height
- curvature of the spine (KYPHOSIS)

Front 6

Major Risk Factors
1. Greatest Predictor
2. others

Back 6

1. Family History of osteoporotic fracture
2. 65 or older, other fractures, Celiac's, EARLY MENOPAUSE, Glucocorticoid therapy

Front 7

Systemic Glucocorticoid Use
1. includes use of what meds ____ + ____
2. Diseases that use this treatment

Back 7

1. Prednisone + cortisone
2. ASTHMA, Rheumatoid arthritis, Crohn's, Colitis, COPD

Front 8

Minor Risk Factors

Back 8

- rhematoid arthritis
- past history of hyperthyroidism
- low dietary Ca intake
- smoker
- excessive alcohol/caffeine
- low weight

Front 9

Non modifiable risk factors

Back 9

- previous fracture
- poor health/frailty
- advanced age
- female sex
- white/asian

Front 10

How is Osteoporosis Measured?
1. Old method
2. New method
3. can better differentiate b/w ____ and _____

Back 10

1. Radiographs
2. DEXA
3. Osteopenia vs Osteoporosis

Front 11

How do you measure Bone Mineral Density?

BMD =

Back 11

take sample of bone
wash out liquid bone marrow
remaining bone is half mineral and half protein

BMD = weight of mineral/volume bone

Front 12

1. DEXA stands for______
2. great for predicting
3. Bone is compared to standard of _____
4. By looking at image how do we know state of bone?

Back 12

1. Dual Energy Xray Absorption
2. whether a person will have a hip fracture
3. 25 year old bone (not age-comparable)
4. The more white = more bone density since rays are stopped by bone mineral/fat/water/protein

Front 13

1. T score = ______
2. Normal Score
3. Osteopenia Score
4. Osteoporosis Score
5. Z score = _______

Back 13

1. # of SDs from average 25 year old woman
2. > -1
3. -1 --> -2.5
4. < -2.5
5. # of SDs below age matched average

Front 14

1. Age risk for men vs women
2. why?

Back 14

1. 65 for men, much higher than women
2. Menopause is reason for earlier age, testosterone doesn't start changing until around 65

Front 15

Bone Remodelling
1. completed every ___ to _____
2. Osteoclasts are
3. Osteoblasts are

Back 15

1. every 3 to 4 months
2. clasts = excavate areas of crumbling/weakened bone
3. blasts = fill crevices w/ material that calcifies to form new bone

Front 16

1. Age that bone stops growing and peak bone mass almost reached in men and women
2. exercise in children does what?
3. Absolute peak at age ____

Back 16

1. Men = 20, women = 16
2. increases one growth by 5-15%
3. 30

Front 17

Bone Mass Loss
1. What age do you begin losing bone mass + how much loss?
2. Women - how much loss after onset of menopause?
3. Men have accelerated bone loss after age ____ + how much loss compared to women?

Back 17

1. 35 + 1%/year
2. 2-5% in first 5-10 years. 45% loss overall
3. age 65, 2/3 the loss of women

Front 18

1. 2 Things to help maintain Bone Mass?
2. Age related factors that cause Osteoporosis

Back 18

1. Physical activity + adequate Ca/Vit D
2. Inefficient bone remodelling + reduced Ca intake/absorption, poor Vit D status, hormonal changes

Front 19

Some factors affecting bone mass Structure

Back 19

Nutrition + Hormones + Exercise/Lifestyle
Falls +

Front 20

Vitamin D and Age
1. After age ___ what happens?
2. found where? (3)
3. decline in what particular synthesis?
4. stored where? + northern phenomenon

Back 20

1. skin doesn't convert vit D as well
2. Natural sunlight + fortified dairy products + meds
3. D3
4. Liver/fat + higher fat storage in north makes up for reduced sun exposure

Front 21

1. Sunscreen with SPF ____ or more block vit D producing UV rays
2. Sun exposure - ______mins of exposure b/w what times is sufficient for VitD synth
3. Optimal Vit D Serum levels

Back 21

1. 8
2. 5-30 mins b/w 10 am - 3pm
3. 75 nmol/L

Front 22

Foods with Vit D
hard to reach daily recommendation through food alone

Back 22

Salmon + Sardines + meat + eggs + liver + milk/margarine/butter

Front 23

STUDY --> Ca attenuates bone loss in women
1. Recommended intake for young adults
2. for older adults
3. excess may lead to ______
4. Calcium sources
5. Keep intake below ______

Back 23

1. 1000mg
2. 1200mg
3. kidney stones
4. cabbage + orange + cheese + milk
5. 2000mg (more than adequate if not better, effective up to an intake threshold)

Front 24

Ca Supplements
1. recommended for who?
2. look for amount of _______Ca because the main ingredient is a compound called ________ so the pure amount of Ca is actually this

Back 24

1. people not getting enough from food + unable to make diet change
2. elemental Ca, Calcium carbonate

Front 25

2 types of Supplements + differences

Back 25

1. Calcium Carbonate - inexpensive, best with food (tums)
2. Calcium Citrate - more expensive, okay on empty stomach

Front 26

Body will do anything to maintain Ca levels because of it importance in ________________ so it may result to taking it from __________ despite the consequences of ________________

Back 26

important to nerve conduction, contractions, heart function
may take from bones
doesn't care if osteo or kidney stones may develop later

Front 27

1. Why are Ca dietary sources best?
Calcium guidelines by age:
2. 4-8
3. 6-18
4. 19-50
5. 50+
6. Preganant

Back 27

1. elemental content is highest, higher absorption rate, lower cost
2. 1000
3. 1300
4. 1000
5. 1200
6. 1000

Front 28

1. Influence of sufficient protein on fracture risk
2. effect of insufficient protein
3. Protein recommendations in g/kg vs RDA
4. when can protein promote bone loss?

Back 28

1. reduces fracture risk
2. Catabolism --> decreased mobility --> increased risk of falling/fracture
3. 1g/kg --- RDA = 0.8g/kg
4. when Ca is inadequate

Front 29

1. Vegetarian diets are insufficient in _____ and ____
2. Vegan diets don't get enough ____ and ___ and ____
3. 5 positive effect nutrients for bone health (MMPZK)
4. 4 things that are bad in excess

Back 29

1. Ca and protein
2. Ca, protein and Vit D
3. Magnesium, Managanese, Phosphorus, Zinc, Vitamin K
4. Vit A, Na, Alcohol, Caffeine

Front 30

1. Vit C key role = + Source
2. Phosphorus __% bone mass + Source
3. Magnesium increases ___
4. Lycopenes, contain ____, found in _____

Back 30

1. Form bone matrix + citrus, tomatoes, cabbage, brocc
2. 50%, dairy, baked goods, legumes
3. bone quality
4. Antioxidants, found in tomatoes, grapefruit, watermelon

Front 31

Nutrient deficiency risk populations (4)

Back 31

1. Strict vegans
2. Restrictive Dieters
3. Frail/Elderly
4. Alcohol problem

Front 32

Caffeine
1. contribute to ____ loss through the _______
2. detrimental amount = ____ per day

Back 32

1. Calcium loss through Kidneys
2. FOUR per day

Front 33

Smoking
Decreases _____ levels and lead to early _______

Back 33

Decreases Estrogen levels
Leads to early Menopause

Front 34

1. Hip protectors in LTC? pros/cons
2. Interventions for fall reduction

Back 34

1. Pros - cost effective, reduction in fractures
Cons - Compliance, not effective in community
2. PA, balance training, home safety assessment, cataract removal

Front 35

Physical Activyt
1. process explaining why its beneficial
2. improves..... but doesn't improve

Back 35

1. PA places increased load on our body and it responds by increasing amount of bone
2. improves balance/coordination, flexibility/posture doesn't improve BONE DENSITY

Front 36

PA
1. early prevention
2. Reversibility
3. Decreasing return

Back 36

1. starting early is best way to prevent later trouble
2. Any gains lost quickly - maintenance is key
3. see changes initially then plateau

Front 37

1. how many men over 50 have osteoporosis? __/__
2. what is main cause of osteo in men
3. diff b/w women and men, men more likely to ______

Back 37

1. 1/8
2. less testosterone
3. later onset and more gradual decrease
4. men more likely to die/ be disabled by hip fracture

Front 38

Reasons for less Osteo in men

Back 38

1. greater peak bone mass
2. no menopause accerlating bone loss
3. don't live as long
4. less likely to fall

Front 39

Fitness benefits

Back 39

- Restful sleep
- health
- improved body comp
- improved bone density
- resistance to disease
- lower cancer risk
- lower CVD/ Type 2, anxiety/depression
- long life + better quality of life

Front 40

1. Anaerobic activity characteristics
2. fuel source =

3. Endurance activities
4. Fuel Source

Back 40

1.high intensity, short duration
2. fuel source = Glucose

3. Low to moderate intensity + long duration (aerobic)
4. Fuel source = FAT

Front 41

% of total kcal
1. Carbs
2. Fat
3. Protein

Back 41

1. 60-70%
2. 20-30%
3. 10-20%

Front 42

Pre game diet features
1. what kind of food
2. how long before
3. avoid ____ and _____

Back 42

1. easy to digest, carb rich
2. 3-4 hours before to allow stomach to empty
3. avoid fibre and fat

Front 43

Post game diet features
1. why is it important
2. what kind of meal
3. how long after

Back 43

1. enhances glycogen storage
2. high carb
3. within 2 hours