OESTEOPOROSIS
A disease of weak and brittle bones
Reduced bone density and quality
Decrease in bone mass and density
Porous and fragile bone increase risks of bone fracture
Fractures can lead to injury or death
Common fractures: spine, hips, wrists
Due to an excessive loss of protein and minerals especially calcium
Bone
Living tissue made of collagen fibres and minerals
Collagen synthesis requires protein and Vitamin C
Minerals such as calcium form a hard structure
Body breaks down, reabsorbs and replaces old tissue
This process slows down with age
Bones become thinner, less dense, brittle, weak
Bones stop growing in length between 16-18 years
Peak bone mass is reached at 25-30 years
Peak bone mass: the maximum amount of bone mass achieved in a lifetime
Causes of osteoporosis
Factors in achieving bone mass: genetic, nutrition, physical activity
Optimise peak bone mass in youth
After 30 irreplaceable calcium is lost and cannot be replaced
Cannot replace tissue as quickly as you lose it
Bone tissue loss increases after menopause
Oestrogen production stops and bones no longer benefit from protective
effect
Low fat tissue results in poor oestrogen production
Why do women suffer more than men?
More the 1/3 over the age of 50 are affected
Nearly 1/2 of those over 70 are affected
One in 5 men will develop this disease
Men have higher bone densities
Smaller and thinner bones
Oestrogen protects bones when young
After menopause oestrogen levels decrease sharply
Bone tissue/density loss increases
Signs and symptoms
Back pain due to cracked or broken vertebra
Decrease in body height
Stooped or bent posture
Bone fractures from mild injury
Bone density scans
Risk factors
Low calcium intake (essential for strong bone formation)
Dietary factors (too little vitamin D, magnesium, phosphorous
Inadequate physical activity (require exposure to weight bearing exercise)
Certain drugs (corticosteroids – interfere with calcium absorption)
Family history of the disease
, Small boned, low body mass
Smoking inhibits absorption of vitamin C
Heavy alcohol, caffeine or soda intake prevents calcium absorption
Anorexia (lower bone mass density)
Hyperactive thyroid
Dowagers hump
Weakened bone collapse’s under body’s weight
Compression fractures occur in the spine
Loss of height
Increased curvature of the spine
Stooped posture
Often visible in the elderly
Prevention
› Recommended daily intake: 1000-1500mg
› Milk and milk products are the best sources
› Adults should have 400ml of milk per day
› Calcium is absorbed less with age
› Increased milk consumption is beneficial
High Calcium › All milk types and yoghurt have similar content
Intake › Green leafy vegetables, tinned fish and nuts are also
good sources
Especially recommended for:
› Children and adolescents
› Breastfeeding women
› Post-menopausal women
› Important for post-menopausal women
› Replaces missing oestrogen with hormone
Hormone
supplement
Replacement
› Slows down the loss of calcium
Therapy
› Reduces bone density loss
› Early menopause (before 45) can cause osteoporosis
› Excessive weight loss
Avoid Bad › Alcohol and caffeine abuse
Lifestyle Habits › Smoking
› Interferes with calcium absorbtion
› Stimulate bone formation
› Reduce bone loss
Regular Exercise › Weight bearing exercises
› Best exercise: cycling, jogging, dancing, or brisk
walking
› Vitamin C forms natural collagen
› Vitamin D helps absorption of calcium and
Sufficient Vitamin phosphorous
and Mineral Intake › Vitamin D sources: oily fish, salmon, egg yolk, milk,
sunlight, tuna
› Phosphorus and magnesium
Increase Fluoride › Found in fluorinated water
› Ensures rapid absorption by bone minerals
, › Helps strengthen bones
RICKETS
The softening and weakening of bones
In children
Softens areas of growing tissue at bone ends
Causes skeletal deformities
Extreme and prolonged vitamin D deficiency
Osteomalacia: rickets in adults
Vitamin D deficiencies are common in developing countries
Vitamin D, calcium and phosphorous work together
Necessary to build strong bones and teeth
Without proper nutrients the body can become malnourished and
deformed
Diagnosed with blood tests and x-rays
Treatable by a medical professional
Treatment: adding vitamin D or calcium to the diet, medication, surgery
Signs and symptoms Complications if left untreated
Delayed growth Failure to grow
Delayed motor skills Abnormally curved spine
Pain in spine, pelvis, legs Bone deformities
Muscle weakness Dental defects
Bowed legs or knock knees Seizures
Thickened wrists or ankles
Breastbone projection
Source of vitamin D: sunlight Source of vitamin D: food
Skin produces it when exposed to sunlight Found in fish oil, egg yolks, salmon and
(10-15mins) but children in developed fatty fish and has also been added to
countries spend less time outdoors and wearsome foods and beverage such as milk
sunscreen which blocks rays and cereal and fruit juices (fortified)
Risk Factors
Dark skin (pigment melanin lowers skin’s ability to produce vitamin D from
sunlight
Vitamin D deficiency during pregnancy
Northern latitudes (geographical locations with less sunlight)
Premature birth (less time to receive vitamin D in the womb)
Medications (anti-seizure, antiretroviral interferes with ability to use
vitamin D)
Exclusive breast feeding (breast milk does not contain enough vitamin D)
, CONSTAPATION
Infrequent bowel movements
Fewer than 3 bowel movements a week
Faeces become hard, lumpy, compacted, dry
Faeces move too slowly through the digestive tract
Effort is needed to remove faeces effectively from the rectum
Hard faeces are painful to pass
Symptoms Risk factors
Lumpy or hard stool Being an older adult
Passing fewer than 3 stools a week Being a woman (especially
Straining to have bowel movements pregnant)
Feeling a blockage in the rectum Being dehydrated
Cannot fully empty rectum Low fibre diet
Needing help to empty rectum Little or no physical activity
(hands to press on abdomen) Mental health conditions
Certain medications
Complications
Hemorrhoids Swollen/inflamed veins in your anus
Straining to have a bowel movement may cause swelling in
the veins in and around your anus.
Anal fissures Torn skin in your anus
A large or hard stool can cause tiny tears in the anus.
Fecal Stool that can't be expelled
impaction
Chronic constipation may cause an accumulation of
hardened stool that gets stuck in your intestines.
Rectal prolapse Intestine that protrudes from the anus
Straining to have a bowel movement can cause a small
amount of the rectum to stretch and protrude from the anus
Diverticular Small, bulging pouches develop in the digestive tract
disease
A disease of weak and brittle bones
Reduced bone density and quality
Decrease in bone mass and density
Porous and fragile bone increase risks of bone fracture
Fractures can lead to injury or death
Common fractures: spine, hips, wrists
Due to an excessive loss of protein and minerals especially calcium
Bone
Living tissue made of collagen fibres and minerals
Collagen synthesis requires protein and Vitamin C
Minerals such as calcium form a hard structure
Body breaks down, reabsorbs and replaces old tissue
This process slows down with age
Bones become thinner, less dense, brittle, weak
Bones stop growing in length between 16-18 years
Peak bone mass is reached at 25-30 years
Peak bone mass: the maximum amount of bone mass achieved in a lifetime
Causes of osteoporosis
Factors in achieving bone mass: genetic, nutrition, physical activity
Optimise peak bone mass in youth
After 30 irreplaceable calcium is lost and cannot be replaced
Cannot replace tissue as quickly as you lose it
Bone tissue loss increases after menopause
Oestrogen production stops and bones no longer benefit from protective
effect
Low fat tissue results in poor oestrogen production
Why do women suffer more than men?
More the 1/3 over the age of 50 are affected
Nearly 1/2 of those over 70 are affected
One in 5 men will develop this disease
Men have higher bone densities
Smaller and thinner bones
Oestrogen protects bones when young
After menopause oestrogen levels decrease sharply
Bone tissue/density loss increases
Signs and symptoms
Back pain due to cracked or broken vertebra
Decrease in body height
Stooped or bent posture
Bone fractures from mild injury
Bone density scans
Risk factors
Low calcium intake (essential for strong bone formation)
Dietary factors (too little vitamin D, magnesium, phosphorous
Inadequate physical activity (require exposure to weight bearing exercise)
Certain drugs (corticosteroids – interfere with calcium absorption)
Family history of the disease
, Small boned, low body mass
Smoking inhibits absorption of vitamin C
Heavy alcohol, caffeine or soda intake prevents calcium absorption
Anorexia (lower bone mass density)
Hyperactive thyroid
Dowagers hump
Weakened bone collapse’s under body’s weight
Compression fractures occur in the spine
Loss of height
Increased curvature of the spine
Stooped posture
Often visible in the elderly
Prevention
› Recommended daily intake: 1000-1500mg
› Milk and milk products are the best sources
› Adults should have 400ml of milk per day
› Calcium is absorbed less with age
› Increased milk consumption is beneficial
High Calcium › All milk types and yoghurt have similar content
Intake › Green leafy vegetables, tinned fish and nuts are also
good sources
Especially recommended for:
› Children and adolescents
› Breastfeeding women
› Post-menopausal women
› Important for post-menopausal women
› Replaces missing oestrogen with hormone
Hormone
supplement
Replacement
› Slows down the loss of calcium
Therapy
› Reduces bone density loss
› Early menopause (before 45) can cause osteoporosis
› Excessive weight loss
Avoid Bad › Alcohol and caffeine abuse
Lifestyle Habits › Smoking
› Interferes with calcium absorbtion
› Stimulate bone formation
› Reduce bone loss
Regular Exercise › Weight bearing exercises
› Best exercise: cycling, jogging, dancing, or brisk
walking
› Vitamin C forms natural collagen
› Vitamin D helps absorption of calcium and
Sufficient Vitamin phosphorous
and Mineral Intake › Vitamin D sources: oily fish, salmon, egg yolk, milk,
sunlight, tuna
› Phosphorus and magnesium
Increase Fluoride › Found in fluorinated water
› Ensures rapid absorption by bone minerals
, › Helps strengthen bones
RICKETS
The softening and weakening of bones
In children
Softens areas of growing tissue at bone ends
Causes skeletal deformities
Extreme and prolonged vitamin D deficiency
Osteomalacia: rickets in adults
Vitamin D deficiencies are common in developing countries
Vitamin D, calcium and phosphorous work together
Necessary to build strong bones and teeth
Without proper nutrients the body can become malnourished and
deformed
Diagnosed with blood tests and x-rays
Treatable by a medical professional
Treatment: adding vitamin D or calcium to the diet, medication, surgery
Signs and symptoms Complications if left untreated
Delayed growth Failure to grow
Delayed motor skills Abnormally curved spine
Pain in spine, pelvis, legs Bone deformities
Muscle weakness Dental defects
Bowed legs or knock knees Seizures
Thickened wrists or ankles
Breastbone projection
Source of vitamin D: sunlight Source of vitamin D: food
Skin produces it when exposed to sunlight Found in fish oil, egg yolks, salmon and
(10-15mins) but children in developed fatty fish and has also been added to
countries spend less time outdoors and wearsome foods and beverage such as milk
sunscreen which blocks rays and cereal and fruit juices (fortified)
Risk Factors
Dark skin (pigment melanin lowers skin’s ability to produce vitamin D from
sunlight
Vitamin D deficiency during pregnancy
Northern latitudes (geographical locations with less sunlight)
Premature birth (less time to receive vitamin D in the womb)
Medications (anti-seizure, antiretroviral interferes with ability to use
vitamin D)
Exclusive breast feeding (breast milk does not contain enough vitamin D)
, CONSTAPATION
Infrequent bowel movements
Fewer than 3 bowel movements a week
Faeces become hard, lumpy, compacted, dry
Faeces move too slowly through the digestive tract
Effort is needed to remove faeces effectively from the rectum
Hard faeces are painful to pass
Symptoms Risk factors
Lumpy or hard stool Being an older adult
Passing fewer than 3 stools a week Being a woman (especially
Straining to have bowel movements pregnant)
Feeling a blockage in the rectum Being dehydrated
Cannot fully empty rectum Low fibre diet
Needing help to empty rectum Little or no physical activity
(hands to press on abdomen) Mental health conditions
Certain medications
Complications
Hemorrhoids Swollen/inflamed veins in your anus
Straining to have a bowel movement may cause swelling in
the veins in and around your anus.
Anal fissures Torn skin in your anus
A large or hard stool can cause tiny tears in the anus.
Fecal Stool that can't be expelled
impaction
Chronic constipation may cause an accumulation of
hardened stool that gets stuck in your intestines.
Rectal prolapse Intestine that protrudes from the anus
Straining to have a bowel movement can cause a small
amount of the rectum to stretch and protrude from the anus
Diverticular Small, bulging pouches develop in the digestive tract
disease
