Lecture 2- 15 Sept 2010
Osteoporosis
Osteo refers to bone and porosis refers to porosity of bone
Although women have almost 2x the hip fracture rate of men the rate in men will increase as life spans increase
Practically everyone over 80 years of age can be said to be osteoporotic and at risk for hip fracture
Today
Pathology
What can be done nutritionally to prevent the pathology or slow or stop its course?
Pathology
Definition-loss of bone tissue to the point that the specific skeletal site is unable to sustain ordinary strains; a specific definition that is based on bone densitometry-based on tissue absorption of photons
Density is mass per unit volume so one is reducing bone density by losing mass relative to volume
A disease that generally manifests itself late in life
-may have its origin in early life during the period of skeletal growth and peak bone mass accumulation
bone loss starts in mid-adult life ie after the age of 40 and continues into old age-all this is a normal processs
bone composition remains the same bone mineral composition and bone mineral density decrease (minerals include calcium, magnesium, copper, fluoride, manganese and zinc)
complex heterogenous disorder of unknown etiology
primarily calcium loss- calcium is being lost faster than it is being replaced
two types of osteoporosis –primary and secondary
primary- type I and type II
primary-type I
-females but rare in males
-post-menopause –50 years
-centre of bone
-lumbar vertebrae and wrists
-loss of estrogen
primary-type II
-female and male
-beyond 65 years
-centre and outside of bone
-hips and vertebrae and all other bones
-aging-otherwise poorly understood
secondary-results when an identifiable drug or disease process causes loss of bone
-drugs -phenytonin (Dilantin)
-phenobarbital
-thyroid hormone
-corticosteroids
-methotrexate
-cyclosporin
-lithium
-aluminum containing antacids
-phenothiazine derivatives
-diseases- hyperthyroidism
-diabetes
-chronic renal failure
-chronic diarrhea or malabsorption
-subtotal gastrectomy
-hemiplegia
Risk factors
-family history of osteoporosis
-female
-white or Asian
-slight body build
-estrogen depletion
-menopause
-early oophrectomy
-hypogonadism
-age especially after sixty
-lack of exercise
-prolonged use of medications
-diseases or conditions that affect calcium and bone metabolism
-underweight or fat
-cigarette smoking
-excessive alcohol consumption
-very excessive fibre consumption
-excessive caffeine consumption
-indequate calcium or vitamin D intake
What can be done nutritionally to prevent the pathology or slow or stop its course?
-estrogen depletion-soy-concept of phytoestrogens
-menopause
-early oophrectomy
-hypogonadism
-underweight or fat achieve normal BMI
-how?
-excessive alcohol consumption-reduce
mechanism-
-very excessive fibre consumption-reduce
phytates
-excessive caffeine consumption-reduce
-mechanism
-inadequate calcium or vitamin D intake
increase- calcium in the bank idea-start early
next day more on diet plus we will talk about functional foods and nutraceuticals