Mar 31 Health - Osteoporosis 2 Flashcards
(18 cards)
Protein and Bone Health:
Expert Consensus review published in 2018 Main findings: (3 things)
- Eating more protein than the basic recommendation (0.8 g/kg/day) may help bones, have higher Bone Mineral Density (BMD), lower risk of hip fracture.
- Protein alone isn’t enough—you need adequate calcium for the benefits to really show up.
- Dairy products are great because they give you both protein and calcium, which work together to support strong bones.
Study within the Expert Consensus CaMOS Study: (2 things)
- Low protein intake (< 12% TEE) was associated with increased fragility
fracture risk - Dairy protein was associated with higher total hip BMD in men and women 50+ y.
Importance of Protein x Ca
- BMD improved with increasing protein intake, as long as current recommended intakes of calcium and vitamin D are met.
NEW Osteoporosis Canada 2023 Updated Nutrition Guidelines: (2 things)
- Osteoporosis Canada endorses the RDA for calcium, vitamin D and protein.
- Dietary patterns and the optimal level of dietary protein for fracture prevention are areas for future study.
Exercise Recommendations for Older Adults
Canadian Society for Exercise Physiology (CSEP): (3 things)
- 150 mins of moderate to vigorous aerobic PA
- Muscle strengthing 2 times a week
- Several hours of light PA including standing and PA that challenges balance
NEW Osteoporosis Canada 2023 Updated Exercise Guidelines:
Prioritize:
Progression: (2 things)
Seek exercise advice and guidance from professionals
* CEP and CPT (CSEP training)
* Physiotherapist/Occupational Therapist
Prioritize:
Other activities encouraged, but prioritize balance, functional, and resistance training at least twice weekly.
Progression:
increase exercise difficulty, pace, frequency, volume or resistance over time.
* Progressive overload
* Individualized approach
Medication Treatment of Osteoporosis
(Name 2)
What do they do?
(2 things)
Bisphosphonates (e.g., Alendronate, Risedronate):
* Stop or slow bone breakdown by reducing the activity of osteoclasts
* They bind to bone, especially where bone is actively being remodeled, and cause osteoclasts to die
Hormone Replacement Therapy -> anti-resorptive therapy
- After menopause, estrogen levels drop, which increases bone breakdown. HRT helps slow bone loss in the early stages of menopause.
- Gives back estrogen (a hormone that protects bones) to postmenopausal women.
Bone Health Athlete Considerations: (2 things)
- Low Energy Availability (LEA)
- Relative Energy Deficiency in Sport (RED-S)
Energy Availability:
Energy is expended during several fundamental physiological processes: (name 4)
Energy expended for one of these processes is not available for others
- Cellular maintenance/metabolism
- Thermoregulation and Immunity
- Reproduction and Growth
- Cognitive function and Locomotion
Energy Availability =
Energy consumed from diet (kcals) minus Energy burned from exercise (kcals) then divided by Kg of Fat Free Mass
Low Energy Availability =
- Energy replete (“normal”) =
- Low EA =
Too much exercise + too little food = not enough energy left for your body to stay healthy.
- Energy replete (“normal”) = 45 kcal/kg FFM/day
- Low EA = < 30 kcal/kg FFM/day
Relative Energy Deficiency in Sport (RED-S):
- Syndrome resulting from chronic low energy availability causing impaired physiological functioning
Female Athlete Triad:
(2 things)
Disordered eating, Amenorrhea, Poor bone health
- First described in 1992 by the American College of Sports Medicine.
- Referring to relationship between energy availability, menstrual function, and bone mineral density.
LEA Prevalence:
Highest risk factor sports:
Risk factors: (Name 4)
Prevalence of LEA ranges from 22-58% depending on sport, population and is not just for females.
Highest risk factor sports:
* Sports involving high training volumes, Weight classes/low body weight and aesthetics (subjectively assessed)
Risk factors:
* Calorie restriction
* Exercise for prolonged periods of time and Training even when injured or sick,
* Pressure to lose weight to improve performance and Competitive nature
* Traumatic event, other life stressors or Change in coaching personnel, other life stressors
RED-S Symptoms: (Name 3)
Symptoms:
* Reduced bone mass or Frequent injuries (stress fractures)
* Menstrual irregularities or Fatigue
* Problems controlling body temp, Sport performance or sleep
RED-S Treatment: (name 2)
Treatment:
* Increase energy intake (~300-600kcal per day) and Reduce energy expenditure
* Counselling (to try to address
underlying factors)
Overview: RED-S/LEA and Bone
Metabolic/Hormonal changes path: (4 steps)
Restrictive eating or Elevated caloric
expenditure -> Metabolic/Hormonal
changes -> Suppressed RMR and Reduced bone formation -> Compromised skeletal health, Fractures and Increased risk for osteoporosis
Overview: RED-S/LEA and Bone
Menstrual Irregularities – low estrogen path: (5 steps)
Restrictive eating or Elevated caloric
expenditure -> Menstrual Irregularities
– low estrogen -> Infertility and Increased bone resorption -> Compromised skeletal health, Fractures and Increased risk for osteoporosis
