Geriatric Topic: Osteoporosis and Diet
Purpose: Osteoporosis which causes bones to become thin and weak is the most common type
of bone disease. According to A.D.A.M Medical Encyclopedia, as many as half of all women
and a quarter of men older than fifty will break a bone due to osteoporosis. Osteoporosis may be
very advanced before you know it and sometimes the first sign you have is a broken bone. It can
be prevented and/or treated.
Objectives:

Explain what osteoporosis means

Discuss the risk factors for osteoporosis

Discuss causes of osteoporosis

Discuss the effects of osteoporosis on other systems

Discuss the role of diet in preventing, and treating osteoporosis.

Provide reliable resources for patients' empowerment through education
What is Osteoporosis?
Osteoporosis (Thin bone, Porous bone, Low bone density) is a metabolic disease which
decreases bone minerals density/mass, thereby putting the individual at risk for fractures. The
most common sites of fracture include the back bones, wrist and the hips. A T-score of less than
-2.5 is diagnostic.
Risk Factors for Osteoporosis
Risk factors for osteoporosis can be grouped into factors we cannot change and factors we can
change.
Risk factors that we cannot change are:

Gender: Chances of developing osteoporosis are greater in women than men. Women
also have less bone mass and tend to loose bone faster than men due to hormonal changes
with menopause.

Age: Our bones become thinner and weaker as we age. So the older you are, the greater
your risk of osteoporosis

Ethnicity: Caucasian and Asian women are at higher risk compared to their African
Americans and Hispanic age mates

Body size: Smaller thin bone women are at greater risk compared to their bigger boned
age mates

Family history: People whose parents have history of fractures also tend to have
decreased bone mass and increased risk for fractures.
Risk factors that we can change include;

Calcium and vitamin D intake: A long term diet low in calcium and vitamin D increases
the chances of osteoporosis.

Sex hormones: Abnormal absence of menstrual periods (amenorrhea), low estrogen level
in men can bring on osteoporosis

Anorexia Nervosa: This is an eating disorder characterized by irrational fear of weight
gain. Anorexia nervosa increases the risk for osteoporosis

Life style: Inactive lifestyle or extended bed rest tend to weaken bones

Certain medications: Long term use of glucocorticoids for conditions such as asthma,
Lupus and rheumatoid arthritis, hyperthyroidism, diabetes, cystic fibrosis, multiple
myeloma, celiac disease, multiple sclerosis, and some anticonvulsants can lead to loss of
bone density. Other medications such as cancer chemotherapies and heparin also affect
bone density.

Having osteopenia (low bone density): A T- score between -1.0 and -2.5 is considered by
many doctors as a precursor to osteoporosis

Drinking a large amount of alcohol: Excessive alcohol intake increases the risk of bone
loss

Smoking: Cigarette is unhealthy for the bones and other systems.
Causes of Osteoporosis
The bone is a living tissue and continuously being broken down and replaced with new ones.
Osteoporosis occurs when:



The body fails to form enough new bones
The body reabsorbs too much existing bone.
Both.
The conditions above could be caused by any of the listed risk factors that we can change.
The nutritional causes of osteoporosis are inadequate calcium which is the most important
minerals needed for bone formation, vitamin D which helps the body absorb calcium, inadequate
vitamin A and K.
Effects of osteoporosis on other system



Effect on body frame and muscles: As osteoporosis weakens the bones and joints, the
normal body structure is deformed. Some muscles such as the back muscles are stretched
while the abdominal muscles are shortened. Osteoporosis eats away the spongy interior
bone so much that a fall, a hard bump into something or even lifting an object might
result in a bone fracture. The condition can get so bad that a person is limited in
movement and activities.
Chronic Pain: Another common effect of osteoporosis on the body is chronic pain. It is
sometimes so severe and disabling. Pain is often caused by compression on the vertebrae,
pressing bone against bones, nerves and surrounding tissue. The pain may also be felt in
the hip, knee, shoulder and wrist joints.
Physical Deformity: In some individuals, osteoporosis can cause the spinal column to
bend forward (called a Dowager's hump) and contribute to overall loss of height. The
effects of compression fractures in the spine often lead to distortions of the spinal
column, creating a stooped appearance.

Compression of Internal Organs: As the spine develops abnormal curves, some
individuals experiencing severe curvature of the spine. They may also suffer from
difficulty breathing and pain in the abdomen as internal organs are also compressed. Lack
of back support caused by curvature of the spine results in the rib cage sinking lower into
the soft tissues of the abdomen and cramping internal organs such as the lungs, stomach
and intestines.
Prevention and Treatment
Osteoporosis is better prevented than treated. Geriatric awareness of this condition will help
recipients to act appropriately towards preventing this condition using diet/nutrition, bone
strengthening exercises, and fall prevention. Geriatric patients should also monitor their height
and obtain an annual bone scan for early detection of osteoporosis. Compliance with medications
such as bisphosphonates, estrogen, calcitonin, hormone therapy as prescribed by patients
physician is highly recommended..
Osteoporosis and Diet: Balanced nutrients are generally needed by the body. Calcium and
vitamin D are needed for strong bones. Sources of calcium include low fat dairy products ( milk,
yogurt, cheese, ice cream), dark green leafy vegetables (broccoli, collard green and spinach),
sardines, salmon with bones, tofu, almonds and foods fortified with calcium (orange juice,
cereals and breads). Calcium supplements may be used in addition to food nutrients if required.
The dietary reference intake for calcium is 1000 mg/day for adults up to 50 and 1200
mg/day for people 51 and older
Vitamin D is an indispensable assistant to calcium in bone building. Vitamin D helps the body
absorb calcium and so adequate vitamin D indirect and positively affects calcium level. Vitamin
D is obtained from fortified milk, fortified cereals, and some fortified yogurts, and eggs. The
body can also manufacture its own vitamin D is exposed to 30 minutes of sunlight between the
hours of 10a.m and 3p.m twice a week. If needed, vitamin D supplement may be used. 1000
IU/day is recommended
Vitamin K helps regulate calcium and build bone. According to the nurses’ health study, women
who took more than 109 mcg of vitamin K daily were 30% less likely to break a hip compared
with those who got less. Vitamin K is obtained from dark green lettuce, broccoli, spinach,
Brussels sprouts and kale.
The dietary recommended intake for vitamin A is 700 mcg for women with level up to 3000mcg
considered safe. The Nurses’ Health Study suggests that menopausal women are best off with
vitamin intake in the lower half of the range.
Finally, limit the following as they affect the absorption of the calcium
Alcohol to 2 drinks a day for men and 1 drink a day for women.
Coffee/tea to 3 cups/day as this interferes with calcium absorption.
Salt not more than 2400mg/day.
Additional reference for you
1.
2.
3.
4.
http://www.nof.org/food
http://patienteducationcenter.org/articles/healthy-eating-beating-bone-loss/
http://www.cdc.gov/nutrition/everyone/basics/vitamins/calcium.html
http://fnic.nal.usda.gov/professional-and-career-resources/nutrition-and-healthorganizations/osteoporosis
5. http://www.nutrition.gov/nutrition-and-health-issues/osteoporosis
Bibliography
1. http://www.bing.com/images/search?q=osteoporosis&FORM=HDRSC2#a
2. http://www.bing.com/images/search?q=sources+of+calcium&qpvt=sources+of+calcium
&FORM=IGRE#a
3. http://intranet.wakehealth.edu/hw/content/twl12404en-us.htm
4. http://www.nof.org/food
5. http://patienteducationcenter.org/articles/healthy-eating-beating-bone-loss/
6. http://www.cdc.gov/nutrition/everyone/basics/vitamins/calcium.html
7. http://fnic.nal.usda.gov/professional-and-career-resources/nutrition-and-healthorganizations/osteoporosis
8. http://www.nutrition.gov/nutrition-and-health-issues/osteoporosis