Nutrition and Bone Health

7/21/2019 Nutrition and Bone Health

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Nutrition and Bone Health

Departemen Ilmu Gizi

BLOK DERMATOMUSKULOSKELETAL

K!UISU" #$$%



& Ade'uate nutrition i( e((ential )or the

de*elopment and maintenan+e o) the(,eleton

& Bone di(ea(e +omple- etiolo.ie(

de*elopment o) di(ea(e /

01 pro*idin.ade'uate amount( o) nutrient(



& 23 1ear(

#34 o) the population 01 #$#$& 5 ri(, o(teoporo(i( and 6dou0lin. or

triplin.7 hip )ra+ture



Bone Ma(( and Bone Den(it1

& Bone ma(( 0one mineral +ontent 6BM87

a((e(in. amount o) 0one a++umulated

0e)ore the +e((ation o) .ro9th

& Bone den(it1 de(+ri0e 0one a)ter thede*elopmental period i( +ompleted



8al+ium Meta0oli(m



8al+ium Homeo(ta(i(



:ea, 0one ma(( 6:MB7

& :MB rea+h ;$ 1ear(

& Lon. 0one (top .ro9in. in len.th a.e <=6)emale(7 and a.e #$ 6male(7

& Man > 9oman

& Hereditar1

& Dietar1 +al+ium inta,e(

& ?ei.ht!0earin. ph1(i+al a+ti*it1

& Bod1 9ei.ht



Lo(( o) 0one ma((

& A.e i( important

& A.e @$ BMD dimini(h .raduall1 60oth

(e-e(7& Lo(( a)ter a.e 3$ 69omen7 or the time

o) the menopau(e <!#4 per 1ear o*er

the ne-t de+ade

& Man lo9er rate than 9omen 6(ame a.e7

& But a.e $ (ame )or 0oth



Di))eren+e 0et9een normal 0one

and o(teoporoti+ 0one



Nutrition and Bone

& 8al+ium" pho(phat" and *itamin D

& Mi+ronutrient

& :h1toe(tro.en(



Re+ommended Inta,e( o) Bone!

Related Nutrition )or Adult(

& 8al+ium <3$$ m.Cda1 )or po(tmenopau(al9omen" <$$$!<#$$ )or 1oun.er 9omen

& itamin D 2$$!<$$$ unit(

& Ma.ne(ium @$$!2$$ m.& Man.ane(e #!3 m.

& in+ <3 m.

& Boron ; m.

& 8opper#!; m.

& itamin K 3$$ m+.



8al+ium Inta,e

& ood (our+e( are re+ommended )ir(t )or

(uppl1in. +al+ium need( 0e+au(e o) the

+oin.e(tion o) other e((en(ial nutrient(

Sour+e(

& 8al+ium )rom )ood

& 8al+ium )rom (upplement& 8al+ium )rom )orti)i+ation )ood



8al+ium )rom )ood

& 8al+ium )rom )ood i(.enerall1 .ood" 0ut )roma )e9 )ood( (u+h a((pina+h it ma1 0e lo9er

& ?heat 0read ma1 0e a.ood (our+e o) +al+ium& Green lea)1 *e.eta0le(

(u+h a( 0ro++oli" ,ale"0o, +ho1" and (o1 0ean6lo9er 9ith o-alate7

& Dair1 produ+t( hi.h!+al+ium mil," +hee(e("1o.hurt 60e(t7



& 8al+ium in (ele+ted

)ood( F To)u F o.hurt F Sardine( F 8ollard .reen("+oo,ed

F 8hee(e F Non!)at mil, F :uddin." *anilla F ?hole mil, F 8u(tard F Buttermil, F I+e!mil, F Spina+h



8al+ium )rom (upplement

& Si.ni)i+ant in+rea(e( in (pinal and total

0od1 BMD

& Good 0ut it (eem( more li,el1 that ,eepin.

the .ain( in BMD a++rued 0e)ore a.e #$

& Be(t +om0ination o) re.ular ph1(i+al

a+ti*it1 and a rea(ona0le +on(i(tent dail1

+al+ium inta,e(



8al+ium 0ioa*aila0ilit1 )rom +al+ium

(upplement

& Depend( on the anion u(ed" 0ut in

mar,et .ood 0ioa*aila0ilit1

& 8al+ium +itrate malate a0(or0ed

e))i+ient than +al+ium +ar0onate and other

+al+ium (upplement(

& 8al+ium +ar0onate +on(tip1in. e))e+t

6minimize 01 di*idin. do(e and ta,in.

more )luid( and )i0er(7



E))e+t o) (upplement

& Hi.h do(e +al+ium (upplement ma1

redu+e the a0(orption o) nonheme iron

and po((i0l1 zin+ Ma.ne(ium" and other

di*alent +ation(



:otential Ri(,( A((o+iated 9ith

E-+e((i*e 8al+ium Supplementation

& 8ontamination o) 0one meal or dolomite(upplement( 9ith +admium" mer+ur1" ar(eni+" or

lead& Urinar1 tra+t or renal (tone( in (u(+epti0le

indi*idual(

& H1per+al+emia or mil, al,ali (1ndrome )rom

e-tremel1 hi.h inta,e( 6>@$$$ m.Cda17& De)i+ien+1 o) iron and other mineral di*alent

+ation( re(ultin. )rom de+rea(ed a0(orption

& 8on(tipation



8al+ium )orti)i+ation o) )ood

& Another 9a1 to in+rea(e the +on(umption

o) +al+ium 01 )emale(

& Oran.e ui+e and man1 0rand( o) non!

dair1 mil,( at a*out ;$$ m.C +up o) ui+e

and to 0readd( and other )ood(

& ood pre)era0le



itamin D

& itamin D inta,e ade'uate *it D inta,e i(

important e-+e(( need i( a*oided

& Sun li.ht e-po(ure )or (,in

& 8al+ium and *itamin D (upplement( are

o)ten .i*en



Ri+,et(



:ho(phat inta,e

& 8al+ium and :ho(phat J << needed )or

mineralization

& Hi.h pho(phoru( 0one lo((

& 8on(umption <$$$ m. to <#$$ m.Cda1

6)emale(7" <#$$!<@$$ m.Cda1 6male7



:rotein inta,e

& Ana0oli+ e))e+t

& Hi.h dietar1 proteinno e))e+t

& Lo9 dietar1 protein Lo9 (erum al0uminlo9

IG!< and (erum +al+ium *ulnera0le )ra+ture

& < .C,. per da1

& Animal protein ri(e urinar1 lo((e( o) +al+ium

6a+id7& :lant proteinlittle e))e+t 6neutral or 0a(i+ urin7



Ma.ne(ium inta,e

& Little e))e+t" 0ut (u..e(t ade'uate inta,e(

o) M. impro*e( BMD

itamin K inta,e

& O(teo+al+in need( *itamin K

& itamin K (upplementation retard 0one lo((



Inta,e( o) other dietar1 +omponent

& Dietar1 )i0er e-+e((i*e inta,e

depre((ion +al+ium a0(orption

& :ota((ium 0i+ar0onate(u))i+ient to

neutralize endo.enou( a+id

& e.etarian diet 0ene)i+ial e))e+t 0u1

pro*ide( le(( +al+ium than animal protein

& I(o)la*on 6ph1toe(tro.en7 (o10ean

lo9er li)etime e-po(ure )or e(tro.en(



& 8a))ein and +ar0onated 0e*era.e(

e-+e((i*e inta,e( deteriou( e))e+t on

BMD

& Inta,e( o) +ola(lo9er BMD

& Al+oholad*er(e e))e+t

Inta,e( o) other dietar1 +omponent



O(teopenia and O(teoporo(i(

& O(teopenia ?hen BMD )all( (u))i+ientl1

0elo9 health1 *alue( 6< SD7 a++ordin.

?HO (tandard

& O(teoporo(i( ?hen BMD 0e+ome( (o

lo9 6.reater than #3 SD( 0elo9 health1

*alue(7



Nutrition mana.ement

& Ade'uate +al+ium inta,e

& Ade'uate*itamin D inta,e )rom )ood"

(upplement" and (un e-po(ure

& A*oidan+e o) e-+e(( phophoru(

& A 0alan+e diet that pro+ide( ade'uate

protein" ener.1" and mi+ronutrient(& E-er+i(e



:re*ention

& Three )a+tor( in)luen+ed 6)or 9omen7 diet"e-er+i(e" and e(tro.en

& Diet +al+ium )rom )ood 6in+ludin.

)orti)ied )ood7" ade'uate inta,e o) *itaminD either )rom (un e-po(ure or )ood( or(upplement

& En.a.in. in re.ular 9ei.ht!0earin.e-er+i(e

& E(tro.en 60e)ore 3$7



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Nutrition and Bone Health