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· REVENTION STRATEGIES THROUGHOUT THE LIFE SPAN: Bone is a dynamic tissue that is constantly undergoing remodeling activity, a function of bone cells, during which old bone is removed and new bone is formed. The factors that determine the level of bone cell activity are mechanical loading, calcium intake, and reproductive hormones. Strategies to decrease risk for osteoporotic fracture should take these factors into consideration throughout the life span since bone mass in the older adult is a product of the amount of bone acquired during growth and subsequent rates of loss during adulthood.
Physical activity has been shown to be an important contributor to bone mass in children prior to adolescence. In addition, this group should have adequate Calcium intake so that the necessary blocks for building bone mineral are present during growth. It has been proposed that young bone may be more responsive to mechanical loading than old bone .Given that approximately 60% of the final
Skeleton is acquired during adolescence, one preventive strategy is to maximize skeletal loading during this rapid phase of growth. It is also important to consider reproductive endocrine status at this time of life. The negative effects of abnormally low estrogen on BMD in amenorrhea women with a high volume of physical training and very low body weight (primarily distance running) are well documented .These effects are even more dramatic in amenorrheic women with anorexia nervosa. Although there is little if any documentation in men, abnormally low testosterone levels are theoretically detrimental for bone.
Preventive strategies in adults are generally aimed at : · maintaining bone mass · reducing the rate of loss. However, recent studies on young adult women indicate that physical activity may play an important role with respect to the capacity to increase bone mass after growth has stopped Recker and colleagues observed increases in spine BMD over a period of five years in a large group of women in their twenties. The increases were related to self-selected physical activity patterns. Adequate calcium intake and maintenance of normal circulating levels of reproductive hormones are still important factors for optimal bone health in adulthood. However, since growth has ceased, recommendations for calcium intake are slightly lower than in adolescence.
· Strategies to prevent fracture in old people: Strategie to prevent fracture in old people must target bone mass as well as factors associated with falls. Several studies have observed beneficial effects of weight training in older populations including increased bone mass, muscular strength, power, dynamic balance, and functional independence. Thus, this may be the best choice of exercise training at this stage in the life span. Most research has focused on machine-based training (e.g., Universal Gym, Nautilus), which requires a seated posture for lower body exercises. While this isolates muscle groups in the legs, it effectively reduces loads at the hip and does not require postural control and balance. To encourage optimal function in a standing posture, older adults should be encouraged to perform exercises such as stepping and rising from a chair. These exercises target muscle groups and actions important for everyday function. While it may seem dangerous for older adults to engage in this type of training, resistance training has proven successful among nursing-home residents, even among quite old adults. The benefits of participation clearly outweigh the risks of immobility, decreased function, and increased likelihood of falls and fracture.
· Assessing Your Risk for Osteoporosis: For each of the following questions, check either yes or no. 1. Do you have a
family history of osteoporosis? (Have any of your relatives broken a wrist
or hip ) 3. Did your menstrual periods ever stop for more than a year for reasons other than pregnancy or nursing? 4. Did your ancestors come from England, Ireland, Scotland, Northern Europe, or Asia, or do you have a small, thin body frame? 5. Have you had surgery in which a part of your stomach or intestines was removed? 6. Are you taking or have you taken drugs like cortisone, steroids, or anticonvulsants over a prolonged period? 7. Do you have a thyroid or parathyroid disorder (hyperthyroidism or hyperparathyroidism)? 8. Are you allergic to milk products or are you lactose intolerant? 9. Do you smoke cigarettes? 10. Do you drink wine, beer, or other alcoholic beverages daily? 11. Do you do less than one hour of exercising such as aerobics, walking, or jogging per week? 12.
Have you ever exercised so strenuously that you had irregular periods or
no periods?
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