Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nutrition & Disease > Week 11 - Osteoporosis and Arthritis > Flashcards

Week 11 - Osteoporosis and Arthritis Flashcards

1
Q

What is Arthritis?

A

Inflamed joints characterised by pain, swelling and stiffness.
Over 100 types of arthritis currently identified.
Joint damage, deformity and loss of mobility cause disability and reduced quality of life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common - arthritis?

A

osteoarthritis
rheumatoid arthritis
gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Common cause of disability in older adults:

A

osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is osteoarthritis? prevalence, sufferers

A

most common form of arthritis
8% prevalence in aus, 12% in indigenous Aus
60% sufferers are female

main symptoms: pain, swelling, joint stiffness

characteristic features: cartilage loss, bony outgrowths, slow progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Osteoarthritis - Risk Factors:

A

non-modifiable:
- age, female, family history

strong, modifiable:
overweight, inactivity, joint trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Obesity-specific mechanisms for osteoarthritis include:

and what % weight loss improves inflammation?

A
  • mechanical stress
  • loss of muscle mass and strength
  • systemic inflammation

5% weight loss improves inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is rheumatoid arthritis?

A
  • auto-immune condition
  • can affect other body parts and organs as well as joints
  • typically characterised by periodic flares and occasional remissions
  • more common between 30-65 years but can occur at any age
  • 2% prevalence rate in Australians/4% indigenous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Abstinence from smoking may reduce risk of what?

A

rheumatoid arthritis among postmenopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Rheumatoid Arthritis - omega-3

A
  • number of studies indicate that omega-3 fatty acids ameliorate symptoms of RA
  • 3g DHA and EPA per day for analgesia of arthritis

unclear if omega-3 fatty acids prevent RA - trend towards a protective effect from fish consumption, RR per 30g/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Rheumatoid Arthritis - omega-3 - Arthritis Australia recommends:

A
  • consumption of oily fish 2-3 times per week

- those with rheumatoid arthritis may benefit from 2.7g / day DHA and EPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dietary Associations Under Investigation:

A

possibly protective:

  • moderate alcohol consumption
  • vitamin D
  • breastfeeding

possibly causative:

  • caffeine
  • red meat
  • obesity (effect on hormones)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is gout?

A
  • form of arthritis characterised by deposits of uric acid crystals in joints.
  • uric acid is not excreted effectively
  • commonly affects men aged 40-50 years
  • rare in females
  • rapid onset
  • attack typically lasts a week, can progress to a chronic condition if not managed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Gout - Risk Factors

A
  • Family history
  • Alcohol
  • Dehydration
  • Overweight
  • Fasting or crash dieting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Gout - Preventive Factors:

A
  • Vitamin C
  • Low fat dairy products
  • or linked to insulin
  • evidence for dietary protection of arthritis is currently very weak
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Gout - best advice at the moment:

A
  • Maintain a healthy weight
  • Quit smoking
  • Eat a varied, balanced diet according to AGTHE
  • Cardiovascular prevention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is osteoporosis?

A
  • A systemic skeletal disease that causes the bones to become thin, weak and fragile.
  • Density and quality of bone are reduced, leading to weakness of the skeleton and increased risk of fracture.
  • Spine, hip and wrist most commonly affected.
17
Q

Bone Composition:

A

Cortical Bone: dense, compact

Trabecular Bone: spongy, porous bone / faster rate of turnover

18
Q

Osteoporosis Impact - Symptoms/Physiological:

A

Disfiguring, painful, debilitating, cascade effect of fractures, fractures associated with morbidity and early mortality

19
Q

Osteoporosis Impact - Australia/Outcomes:

A
  • 25% of those who sustain a hip fracture die within 11 months
  • 50% require long-term help with routine activities and cannot walk unaided
  • 25% require full-time nursing home care
20
Q

Assessing Bone Health:

A

Dual Energy X-Ray Absorptiometry (DXA):

- Compares bone density to a 30 year old healthy adult
T-Score / Diagnosis:
\+ 1 to -1: Normal
-1 to -2.5: Poor Bone Density
below -2.5: Osteoporosis
21
Q

Osteoporosis: Non-modifiable Risk Factors

A

Ethnicity: more common in caucasian, asian and hispanic populations.
Less common in African-American populations

Age
Female gender
Family History

22
Q

Osteoporosis - Age

A

Birth - 20 yrs = bone growth
12 - 30 yrs = development of bone growth
Most people reach peak bone mass in their 20s
30-40 yrs bone loss commences, continues throughout life

23
Q

Osteoporosis - Gender

A

Men have greater bone density than women at maturity. Women have greater bone losses than men in later life - decline in calcium absorption post menopause.
Men develop bone problems about 10 years later in life.
Diabetes and some diabetes medication associated with more rapid bone demineralisation.

24
Q

Osteoporosis - Modifiable Risk Factors:

A 
Excess alcohol
Smoking
Low BMI
Sedentary lifestyle
Low calcium, vitamin D
Mediterranean diet
25
Q

Osteoporosis - Alcohol

A
  • bone density is higher in moderate drinkers
  • consumption of more than 2 standard drinks increases risk of osteoporotic and hip fractures in men and women
  • Possible explanations:
  • low bone mass because alcohol has toxic effect on bone-forming osteoblasts
  • alcohol affects PTH, calcitonin and growth hormone
  • increased fluid losses - excess calcium excretion
  • liver damage interferes with vitamin D metabolism
  • alcoholics have poor dietary intake
26
Q

Osteoporosis - Smoking

A
  • Dose-response relationship between smoking and risk of hip fracture
  • smokers have lower bone density
  • second-hand smoke may also be damaging
  • possible explanations: smoking reduces levels of oestrogen, other bone-related hormones, smokers are thinner / exercise less
27
Q

Osteoporosis - Body Weight

A

Women with higher BMI have slightly higher bone mineral density:

  • Increased load on skeleton, oestrogen
  • Higher intakes of nutrients

BMI >26-28 may be protective
BMI 22-24 may have greater risk

28
Q

Osteoporosis - Physical Activity

A

Helps develop peak bone mass, minimise bone loss

weight-bearing and high impact exercise require to stimulate bone formation: walking/running, skipping, lifting weights, jumping
short duration, intense exercise builds bone most efficiently
exercise that improves posture and balance protects from falls - yoga tai chi etc.

29
Q

Osteoporosis - Calcium:

(what is the supplement if RDI cannot be achieved?

A
  • Most older men and women are unlikely to meet the RDI.

- When the RDI cannot be achieved, a daily supplement of 500-600mg/day is recommended.

30
Q

Osteoporosis - Vitamin D

A
  • Well established link with Vit D deficiency, reduced bone mineral density and increased risk of fracture.
  • Severe vitamin D deficiency also assoc. with loss of lower extremity muscle mass and strength and impaired balance in the elderly.
  • Most australian adults are unlikely to obtain more than 5-10% of their vitamin D requirement from dietary sources.
31
Q

Adequate vitamin D is considered to be:

And supplementations:

A

> 50nmol/L

at least 600IU/day for people under 70
at least 800IU/day for people over 70
sun avoiders may require 1000-2000 IU/day

32
Q

Osteoporosis - Nutrition - Potentially Beneficial

A

Protein: required for bone tissue growth, repair and development

Boron: may enhance calcium absorption and oestrogen metabolism

Iron, Manganese, Vitamin C, Zinc: required for enzymes involved in formation of bone matrix

33
Q

Osteoporosis - Nutrition - Potentially Adverse:

A

Caffeine: may interfere with calcium absorption (possibly neutralised in presence of adequate calcium)

Protein: high protein intake may interfere with calcium status

Fibre, Oxalates:
negative impact on calcium absorption

Sodium: increases urinary calcium loss (neutralised in presence…)

Vitamin A: required for bone growth but excessive amounts of retinol increases bone breakdown and interferes with Vitamin D

34
Q

Fruit and vegetables - bone health

A

Improves - likely due to increased intake of magnesium, vitamin C and vitamin K

35
Q

Osteoporosis - EATING DISORDERS:

A

Osteoporosis develops in about 30-50% of cases of anorexia nervosa. Reduced calcium intake accelerates mineral loss from bone. Oestrogen deficiency prevents development of peak bone mass and hastens bone loss.
Low body weight therefore reduced load bearing.

36
Q

Osteoporosis - Preventative Strategies:

A
  • Consume a varied diet
  • Lifetime diet adequate in calcium
  • Lifetime adequate vitamin D status
  • Be physically active
  • Avoid smoking
  • Moderate alcohol consumption

Nutrition & Disease (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions